| NPI | 1184882219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RICHARD MUSAL Owner 765-288-5527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12010472A) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |