Organization
GREEN RIVER FAMILY DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY M HALLER D.D.S. (PRESIDENT)
(812) 476-3131
Entity
Organization
Contact information
Practice address
207 S GREEN RIVER RD, EVANSVILLE, IN 47715-7334
(812) 476-3131
(812) 476-6621
Mailing address
207 S GREEN RIVER RD, EVANSVILLE, IN 47715-7334
(812) 476-3131
(812) 476-6621
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12007860
IN
Other
Enumeration date
12/10/2008
Last updated
12/10/2008
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