NPI | 1588289169 |
---|---|
Former Legal Business Name | BRUSH DENTAL |
Entity Type | Organization |
Authorized Contact | BRADLEY DANIEL HUGHES Dentist/ Owner Of Business 260-563-4065 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2020-06-10 |
Last Update Date | 2020-06-10 |