| NPI | 1245213867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EVAN DIXON President 574-892-5513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009813) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2020-08-22 |