| NPI | 1093775272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD J ASDELL Owner 574-289-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12008287) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2012-04-18 |