| NPI | 1891883633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADFORD HENRY KORN President 260-432-3588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IN 12007256) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |