| NPI | 1417351339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC NEWMAN Dds 317-803-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IN 11655) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-21 |