| NPI | 1770767816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERA ANDJELKOVIC Dentist 219-661-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12008640) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2007-12-26 |