| NPI | 1730431826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JOSEPH KING Owner 574-293-4213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 1200-9912A) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2012-10-12 |