| NPI | 1740454230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA L. PRITCHARD Office Manager 219-462-0780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12007779A) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |