| NPI | 1619268265 |
|---|---|
| Doing Business As | MARTINSVILLE ORAL & MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | SCOTT E TATE Owner 812-323-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12010196) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2011-04-29 |