| NPI | 1891973541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S MCBRIDE Owner/Partner 574-293-8211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12008926) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2017-11-15 |