| NPI | 1457850687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS J KOSEK Owner 574-340-3423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009873) |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2018-02-02 |