| NPI | 1891379889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ISAACS Owner 317-850-0710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2024-05-08 |