| NPI | 1588873806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT K CAVANAUGH Orthodontist 219-476-4110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12010044A) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12005966A) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12010862A) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-08-24 |