| NPI | 1568580470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DAVID HALLER President 260-489-6544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12008792) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2008-06-18 |