| NPI | 1720455728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE A MIGHION President/Owner 574-256-1579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12009876) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2015-08-25 |