Organization
BRANDYWINE DENTAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN L. KIRKWOOD D.D.S (OWNER)
(317) 462-3456
Entity
Organization
Contact information
Practice address
101 N STATE ST, GREENFIELD, IN 46140-2177
(317) 462-3456
(317) 462-3465
Mailing address
101 N STATE ST, GREENFIELD, IN 46140-2177
(317) 462-3456
(317) 462-3465
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1209025
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000104288
BC/BS PIN
IN
Enumeration date
05/01/2006
Last updated
08/22/2020
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