| NPI | 1124542139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE HAUGHTINGTON Partner/Dentist 219-872-2110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: 12009354) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |