| NPI | 1972359370 |
|---|---|
| Doing Business As | LILAC PEDIATRIC DENTAL |
| Entity Type | Organization |
| Authorized Contact | FLYNNE V WEINGARTEN President, Owner 574-303-2533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2024-04-26 |