Great Lakes Family Dental Group-Muncie, P.c.

NPI #1437557345 in Muncie, Indiana

Provider Information

NPI Number: 1437557345
Entity Type: Organization
Organization Name: Great Lakes Family Dental Group-Muncie, P.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 9, 2014
Last Updated: Dec 9, 2014

Practice Location

Address: 1003 W. MCGALLIARD ROAD
City: Muncie
State: Indiana
ZIP Code: 47303
Phone: (765) 288-1307

Authorized Official

Name: MRS. PATRICIA J. HART
Title: CORPORATE MANAGER
Phone: (810) 625-2860

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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