| NPI | 1811468929 |
|---|---|
| Doing Business As | INDEPENDENCE ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | TYLER PARISI Business Manager 267-225-3056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |