| NPI | 1144480179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JANE JOHNSON Dentist 260-824-5940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010359) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2008-06-12 |