# 42 NORTH DENTAL CARE OF INDIANA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** -
- **Other names:** Greenleaf Family Dentistry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477254399
- **Legal business name:** -
- **Authorized official:** MICHAEL ANGELO SCIALABBA (CHIEF DENTAL OFFICER)
- **Authorized official phone:** (561) 512-2709

## Contact information

- **Practice address:** 1520 OSOLO RD, ELKHART, IN 46514-4122
- **Practice address phone:** (574) 262-9619
- **Mailing address:** 200 5TH AVE FL 3, WALTHAM, MA 02451-8759

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 03/16/2023
- **Last updated:** 03/16/2023