| NPI | 1295940518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA M NUKES Business Manager 574-245-7503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12008118) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2013-06-11 |