| NPI | 1720330004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY PAPADOPOULOS Practice Co Owner 765-281-1131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: IN 12008702A) |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: IN 12010966A) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |