| NPI | 1912435843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID TALER Owner 317-849-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IN 12011831A) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2017-05-24 |