| NPI | 1558610352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY HINGLE President 574-361-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019028281) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-09-07 |