| NPI | 1124127832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A SHUPE President 260-422-8419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 54000026A) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |