| NPI | 1588794168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW BRUCE LOGMANN Dentist/Corporate President 219-844-3635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12007813A) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2011-09-08 |