| NPI | 1558591834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ARCH Registered Agent 219-983-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12008672) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2009-07-21 |