| NPI | 1548709900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN PRESTON EADY President 260-459-1415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12009115) |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2017-02-17 |