Individual
DAVID L VAN WORMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
312 NORTH LAKE ST., WARSAW, IN 46580
(574) 269-1952
Mailing address
312 NORTH LAKE ST., WARSAW, IN 46580
(574) 269-1952
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009888
IN
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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