| NPI | 1639566110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA M ZAEGEL President/CEO 260-458-2646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2024-07-28 |