| NPI | 1962078642 |
|---|---|
| Doing Business As | PERIODONTAL ASSOCIATES OF SOUTH BEND |
| Entity Type | Organization |
| Authorized Contact | GLORIA ROYER Practice Manager 765-447-9319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-06-02 |