| NPI | 1457462590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS T TEEL Owner President 260-432-0561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12009882) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IN 9047) |
| 1223G0001X Dentist General Practice (Licence: IN 9757) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |