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General NPI Number Information
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NPI Number | 1669818241
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Entity Type | Organization
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Legal Business Name | GREENCASTLE FAMILY DENTAL LLC
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 403 N INDIANA ST
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City | GREENCASTLE
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State | IN
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Zip | 46135-1020
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Country | US
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Telephone | 765-653-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 403 N INDIANA ST
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City | GREENCASTLE
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State | IN
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Zip | 46135-1020
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. STEVEN C SALKELD
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Credential | DDS
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Telephone | 765-653-9300
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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 | 12009491A
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License Number State | IN
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