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 |