| NPI | 1548465339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY C PLATT President 219-864-1133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12008814A) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2007-08-22 |