| NPI | 1477703817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE JEAN WILLIAMSON President 219-663-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12008946A) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |