| NPI | 1457573669 |
|---|---|
| Other Name | BROAD SMILE DENTAL |
| Entity Type | Organization |
| Authorized Contact | R JASON SCHNEPF Dentist 219-922-7870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010464A) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-09-25 |