| NPI | 1649438813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP J CASCIONE Owner 765-482-0580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12008558A) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2013-05-09 |