| NPI | 1669596326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ARCH Secretary 219-983-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12008672) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |