| NPI | 1235354341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE E NAGEL President 219-872-9151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12007167A) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |