| NPI | 1194265553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVIS L BARKER Partner 574-291-8022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011066A) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |