Individual
DR. MOHAMED OWAIS SULTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
857 S AUTO MALL RD STE 4, BLOOMINGTON, IN 47401-5488
(812) 339-4400
Mailing address
857 S AUTO MALL RD STE 4, BLOOMINGTON, IN 47401-5488
(812) 339-4400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013044A
IN
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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