# GREEN DENTAL OF OWEN COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689107559
- **Authorized official:** BROOKS ANDREW GREEN DDS (OWNER/DENTIST)
- **Authorized official phone:** (812) 829-2261

## Contact information

- **Practice address:** 51 N MAIN ST, SPENCER, IN 47460-1311
- **Practice address phone:** (812) 829-2261
- **Practice address fax:** (812) 829-2263
- **Mailing address:** 51 N MAIN ST, SPENCER, IN 47460-1311
- **Mailing address phone:** (812) 829-2261
- **Mailing address fax:** (812) 829-2263

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12012283A | IN | Yes |

## Other

- **Enumeration date:** 04/07/2017
- **Last updated:** 04/07/2017