| NPI | 1528118148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE IRMA GAMBETTA Secretary 219-923-3391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010023A) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |