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 |