Hirut Manmektot Kassa

NPI #1629680095 in Griffith, Indiana

Provider Information

NPI Number: 1629680095
Entity Type: Individual
Name: Hirut Manmektot Kassa
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Aug 18, 2020
Last Updated: Aug 18, 2020

Practice Location

Address: 1515 W 45TH AVE
City: Griffith
State: Indiana
ZIP Code: 46319-3801
Phone: (219) 922-9007

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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