| NPI | 1477869378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD M SAMMONS Dentist 765-447-6808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12009779A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12006588A) |
| 122300000X Dentist (Licence: IN 12011006A) | |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2020-07-15 |