| NPI | 1518045574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE PARK Dentist 260-490-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010099B) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |