NPI | 1679746580 |
---|---|
Doing Business As | NORTHEAST ORAL & MAXILLOFACIAL SURGERY |
Entity Type | Organization |
Authorized Contact | WENDY S BEARD Office Manager 317-841-1100 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12007989B) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12007989A) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12010961A) | |
Enumeration Date | 2008-04-11 |
Last Update Date | 2010-02-12 |