| NPI | 1043549009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD G PRUSZ Dentist 812-853-2961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12007170B) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: IN 12010766A) |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2009-12-21 |