| NPI | 1578959375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LEE RUMBAUGH President 260-637-6976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12008140A) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2015-04-09 |