| NPI | 1316176803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANNE BAIN Owner 260-563-4065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN IN12007971) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2009-07-07 |