NPI | 1649325507 |
---|---|
Entity Type | Organization |
Authorized Contact | JAY ALAN HOLLANDER President 317-259-1501 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12007775A) |
Enumeration Date | 2007-01-23 |
Last Update Date | 2020-08-22 |