| NPI | 1578815163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LELAND C WILHOITE Single Member 765-808-1393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009897) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-10-08 |