| NPI | 1356586382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL WAKIM Owner 574-272-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011100A) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2008-12-04 |