| NPI | 1497147086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA GANG Front Office 219-836-2092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011539A) |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2015-02-19 |