| NPI | 1245688282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH E HICKEY Dentist Owner 574-274-7778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011040A) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |