| NPI | 1801316864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN SALAZAR Owner 317-363-4760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010930A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12011038A) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2017-06-21 |