| NPI | 1508236399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMMI FROEDGE Office Manager 765-362-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12008572A) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-06 |