| NPI | 1649395567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MYERS PUNTILLO President 219-662-2264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12009367A) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-03-19 |