| NPI | 1003155300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD W SPENCER Secretary 260-356-9550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 54000832A) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-02-06 |