| NPI | 1326399130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD JON PULFER President 260-471-1695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12010676A) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |