| NPI | 1881708683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL BERNARD GLASS President/Dentist 574-234-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009864A) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |