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General NPI Number Information
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NPI Number | 1073976585
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Entity Type | Organization
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Legal Business Name | DAVID ANTHONY NOLES FAMILY DENTAL, LLC
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 1315 W WESTRIDGE PKWY
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City | GREENSBURG
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State | IN
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Zip | 47240-3251
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Country | US
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Telephone | 812-663-7515
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Fax | 812-663-3518
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Provider Business Mailing Address
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Address Line | 1315 W WESTRIDGE PKWY
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City | GREENSBURG
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State | IN
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Zip | 47240-3251
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Country | US
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Telephone | 812-663-7515
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Fax | 812-663-3518
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Authorized Official
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Title or Position | OWNER/DENTIST/SOLE MEMBER
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Name | DR. DAVID ANTHONY NOLES
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Credential | D.D.S.
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Telephone | 812-663-7515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12012284A
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License Number State | IN
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