NPI | 1467578344 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN MICHAEL GREEN President 317-482-7900 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 8575) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2007-03-22 |
Last Update Date | 2021-10-20 |