Great Lakes Family Dental Group-Muncie, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12012248A Issued in IN

Legal business name

GREAT LAKES FAMILY DENTAL GROUP-MUNCIE, P.C.

Practice address

1003 W. McGalliard Road
Muncie, IN 47303

Phone

(765) 288-1307

NPI assigned

Dec 9, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Patricia J. Hart

Title

Corporate Manager

Phone

(810) 625-2860

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1437557345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 W. MCGALLIARD ROAD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47303",
            "telephone_number": "765-288-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 W. MCGALLIARD ROAD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47303",
            "telephone_number": "765-288-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES FAMILY DENTAL GROUP-MUNCIE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CORPORATE MANAGER",
        "authorized_official_telephone_number": "810-625-2860",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012248A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Anne Gray
• Lynsi Nicole Gray
• Wayne L Gray, MD
• Aurelia Grayam
• Molly Tripp Graybeal, WNHP
• Austin Greene, RBT
• Joshua David Greenlee, O.D.
• Mayson Greer
• Joseph Randall Gregg, D.D.S, M.S.D
• Christopher Gregory, PHD

• General Practice Dentistry in Muncie, IN
• Providers in Muncie, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.