| NPI | 1588703250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATILDA PEREZ Office Manager President 219-769-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IN 12008668A) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IN 12009309A) |
| 1223E0200X Dentist, Endodontics | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |