| NPI | 1760461339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY A PLISKE Owner 812-333-2614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12008000/12009582) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2020-08-22 |