| NPI | 1225417017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY BURKART Office Manager 574-255-0035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 8965) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |