| NPI | 1902814684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM S ANDERSON Doctor 219-962-8586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 54000969A) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-08-22 |