| NPI | 1871699082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L DRURY President 574-264-9015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 54000959A) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2020-08-22 |