| NPI | 1942338231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D. SHAFER Owner 574-277-7995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009526) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |