NPI | 1750660221 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES GABRIEL POPOVICH CEO 219-663-0252 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IN 12010460A) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12006634) |
Enumeration Date | 2011-08-15 |
Last Update Date | 2011-08-15 |