| NPI | 1528112562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY E SHIVELY Office Manager 260-432-2813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IN 12007603) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IN 12007705) |
| 1223E0200X Dentist, Endodontics (Licence: IN 12007721) | |
| 1223E0200X Dentist, Endodontics (Licence: IN 12010480) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |