| NPI | 1083727291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES RANDALL HUTTON President 574-946-6820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 54000691A) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-03-12 |