| NPI | 1942210836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON L MOHR Dentist Owner VP 765-463-9505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010501A) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |