NPI | 1992159552 |
---|---|
Entity Type | Organization |
Authorized Contact | WENDY S. BEARD Office Manager 317-841-1100 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12010961A) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12012362A) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12007255A) | |
Enumeration Date | 2016-04-20 |
Last Update Date | 2016-04-20 |