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1609962646
BRETT MICHAEL DISALLE
FORT WAYNE, IN
NPI
1609962646
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IN 12009812)
Enumeration Date
2006-10-05
Last Update Date
2007-07-08
Business Address
Dr. BRETT MICHAEL DISALLE DDS
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 260-460-1353
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Mailing Address
Dr. BRETT MICHAEL DISALLE DDS
430 AUGUSTA WAY
FORT WAYNE, IN 46825-2175
Phone number: 260-497-9615
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