| NPI | 1992898241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE PHILIP BENIFIEL President 574-277-7733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12008886) |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2020-08-22 |