| NPI | 1982724589 |
|---|---|
| Doing Business As | NORTHWEST INDIANA CENTER FOR DENTAL IMPLANTS |
| Entity Type | Organization |
| Authorized Contact | RICHARD A GUACCIO President 219-865-3050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12006450) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |