| NPI | 1356898050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER K SHIEH Owner 219-716-1259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011455A) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12011456A) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2016-09-09 |