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Organization

GREENCASTLE 20/20 DENTAL, LLC

Active
Parent organization
20/20 DENTAL, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
20/20 DENTAL, LLC
Authorized official
DR. RONALD I PROKES DDS (OWNER)
(317) 727-1534
Entity
Organization

Contact information

Practice address
819 E FRANKLIN ST, GREENCASTLE, IN 46135-1691
(765) 653-5501
Mailing address
819 E FRANKLIN ST, GREENCASTLE, IN 46135-1691
(765) 653-5501

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011722A
IN

Other

Enumeration date
12/17/2014
Last updated
12/17/2014
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