| Brandywine Dental Group, P.c. | |
|
101 N State St Greenfield IN 46140-2177 | |
| (317) 462-3456 | |
| (317) 462-3465 |
| Full Name | Brandywine Dental Group, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 N State St, Greenfield, Indiana |
| Authorized Official Name and Position | Brian L. Kirkwood (OWNER) |
| Authorized Official Contact | 3174623456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandywine Dental Group, P.c. 101 N State St Greenfield IN 46140-2177 Ph: (317) 462-3456 | Brandywine Dental Group, P.c. 101 N State St Greenfield IN 46140-2177 Ph: (317) 462-3456 |
| NPI Number | 1215995279 |
|---|---|
| Provider Enumeration Date | 05/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215995279 | NPI | - | NPPES |
| 0000000104288 | Other | IN | BC/BS PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1209025 (Indiana) | Primary |
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