| NPI | 1174656342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE OSTERMILLER WOLF Dentist 219-362-3730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12008861) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |