| NPI | 1588765077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L FREID President 574-232-4868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12006859A) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-06-18 |