| NPI | 1184752032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C GEPHARDT President 765-643-3061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 54000501A) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |