NPI | 1790359370 |
---|---|
Entity Type | Organization |
Authorized Contact | FAITH ANN HAUPT Business Office Manager 219-985-3133 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2021-05-18 |
Last Update Date | 2021-05-18 |