| NPI | 1487772497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS R LANGEFELD Partner 841-658-8508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019015215) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019020754) |
| 122300000X Dentist (Licence: IL 019025622) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |