| NPI | 1497153142 |
|---|---|
| Doing Business As | NORTHSIDE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | NATHAN S MARTIN Owner/Dentist 317-519-6978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12012108A) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2014-12-11 |