| NPI | 1538347745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID F FISHBAUGH Owner 574-273-8393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12009640) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: IN 12009640A) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2012-04-25 |