Provider Demographics
NPI:1235208539
Name:AFDG, P.C.
Entity Type:Organization
Organization Name:AFDG, P.C.
Other - Org Name:GREENSBURG GENTLE DENTIST
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOAGLENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-423-9111
Mailing Address - Street 1:1815 N GREENSBURG XING
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-8587
Mailing Address - Country:US
Mailing Address - Phone:812-663-6263
Mailing Address - Fax:
Practice Address - Street 1:1815 N GREENSBURG XING
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-8587
Practice Address - Country:US
Practice Address - Phone:812-663-6263
Practice Address - Fax:812-663-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty