| NPI | 1902154248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID M BUKSAR Owner 765-896-9857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009906a) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-08-16 |