| NPI | 1669569893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP KARL RADTKE President 219-879-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IN 12009839A) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |