Individual
DR. GORDON P. BAUSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 N. FRONT ST., RENSSELAER, IN 47978
(219) 866-4533
Mailing address
210 N. FRONT ST., RENSSELAER, IN 47978
(219) 866-4533
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
IN7571
IN
Other
Enumeration date
01/21/2009
Last updated
01/21/2009
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