| NPI | 1154411163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY A JAMES Office Manager 765-446-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2009-02-27 |