Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 12007164 | IN |
NPI | 1063436608 |
---|---|
Provider Name | Dr. James V Macri |
First Address | Granger, IN 46530 |
Second Address | Granger, IN 46530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 22/01/2015 |