NPI | 1457908667 |
---|---|
Doing Business As | SOUTHPORT SMILES FAMILY AND COSMETIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | BETHANY GEYMAN Dentist 317-507-1568 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2019-08-22 |
Last Update Date | 2019-08-22 |