| NPI | 1831264324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELESTE C SHOLL Cda 260-423-2340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-07-09 |