Individual
JOHN WADAS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
417 RIDGE RD, A, MUNSTER, IN 46321-1570
(219) 836-9841
Mailing address
417 RIDGE RD, A, MUNSTER, IN 46321-1570
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012110A
IN
Other
Enumeration date
05/23/2014
Last updated
05/23/2014
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