| NPI | 1619072147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOHN ANGLEMIRE Owner / President 574-277-5406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12007958B) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12009209B) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-09-14 |