| NPI | 1053390989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE M. WONG Vice President & Co Owner 219-769-8788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12008742) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-08-22 |