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1972119030
ORA NW INDIANA, LLC
CROWN POINT, IN
NPI
1972119030
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Entity Type
Organization
Authorized Contact
DANIEL MCGONIGLE
VP
708-906-4236
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center Dental
Enumeration Date
2020-09-23
Last Update Date
2020-09-23
Business Address
ORA NW INDIANA, LLC
10705 RANDOLPH ST
CROWN POINT, IN 46307-7615
Phone number: 219-779-9114
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Mailing Address
ORA NW INDIANA, LLC
10705 RANDOLPH ST
CROWN POINT, IN 46307-7615
Phone number:
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