| NPI | 1982925905 |
|---|---|
| Doing Business As | INNOVATIVE ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | JASON K BUNCH Orthodontist/ Co Owner 765-459-3145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12010651A) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: IN 8906IN) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2010-06-14 |