| NPI | 1154770733 |
|---|---|
| Doing Business As | GREENWALT FAMILY DENTISTREE |
| Entity Type | Organization |
| Authorized Contact | BRANDON LEE GREENWALT President 317-408-5764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN19737) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-06-06 |