NPI | 1023201175 |
---|---|
Entity Type | Organization |
Authorized Contact | TRINODA RADCLIFFE Owner 219-880-1430 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010399A) |
Enumeration Date | 2007-08-22 |
Last Update Date | 2008-07-25 |