| NPI | 1760238497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL COMBS Practice Coordinator/Office Manager 260-918-7110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-04-24 |