| NPI | 1487403838 |
|---|---|
| Doing Business As | SOUTH LOOP DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ANDREW BLOOM Owner 317-696-9011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-05-17 |