| NPI | 1255843116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA JOANNE SCHNEIDER Office Manager 765-463-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2017-11-01 |