| NPI | 1386899821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA E KENFIELD Owner 219-769-1485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011101A) |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2008-11-25 |