| NPI | 1760586887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK R ROSENTHALL President 765-289-2377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12010065) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-08-22 |