| NPI | 1013299429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY G APPLEGATE Owner 765-747-9611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009616) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2011-09-12 |