| NPI | 1710422357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG W. HORSTMEYER Dentist 765-644-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12008398) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2017-01-05 |