| NPI | 1497858864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ELLIOT RISSER Owner 574-232-5866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IN 12010063a) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2009-03-23 |