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Contact Information

GREAT LAKES FAMILY DENTAL GROUP-MUNCIE, P.C.
1003 W. MCGALLIARD ROAD
MUNCIE, IN47303
 Phone: 765-288-1307
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for GREAT LAKES FAMILY DENTAL GROUP MUNCIE PC · (Female)

NPI # 1437557345
Status Active
Credentials
Entity Individual
Enumeration date 12/09/2014
Last updated 12/09/2014 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 12012248A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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