| NPI | 1053411645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIDAS THOMAS NOREIKA President 219-872-2116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 54001178A) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2020-08-22 |