| NPI | 1972716199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD D. BURNS Owner 574-875-8196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12009006a) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |