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Organization
42 NORTH DENTAL CARE OF INDIANA, LLC
Active
Organization
42 NORTH DENTAL CARE OF INDIANA, LLC
Active
Parent organization
-
Other names
Greenleaf Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
-
Authorized official
MICHAEL ANGELO SCIALABBA (CHIEF DENTAL OFFICER)
(561) 512-2709
Entity
Organization
Contact information
Practice address
1520 OSOLO RD, ELKHART, IN 46514-4122
(574) 262-9619
Mailing address
200 5TH AVE FL 3, WALTHAM, MA 02451-8759
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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