| NPI | 1790909000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MICHAEL MCLEOD President 574-233-7331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009809A) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |