| NPI | 1710381496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE ALAN NODINE Owner/Dentist 260-824-2442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12007048A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12011131A) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-09 |