NPI | 1891063368 |
---|---|
Entity Type | Organization |
Authorized Contact | CAMERON H CONKIN Oral And Maxillofacial Surgeon 317-882-2595 |
Organization Subpart ? | No |
Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: IN 12011582A) |
Enumeration Date | 2011-12-12 |
Last Update Date | 2011-12-12 |