Individual
ANGELA L GREENAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
10106 BROOKS SCHOOL RD, SUITE 500, FISHERS, IN 46037-9804
(317) 596-8000
(317) 596-0671
Mailing address
10106 BROOKS SCHOOL RD, SUITE 500, FISHERS, IN 46037-9804
(317) 596-8000
(317) 596-0671
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
BG12010154A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00720339
PROVIDER
IN
Enumeration date
08/09/2006
Last updated
07/09/2007
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