| NPI | 1053648055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT HEWITT President 574-532-3085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12007801A) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2009-11-11 |