| NPI | 1720472392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BYRON LEON COHEE Owner/President 765-473-5959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN IN12008206A) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |