| NPI | 1588895585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN A. NATT Owner/President 219-322-1852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 54001643A) |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2009-08-07 |