| NPI | 1891055968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD F ANGLIS Owner 219-226-9380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12007805B) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2012-05-23 |