MEDICARE: ROBERT O GREER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0106X	Oral and Maxillofacial Pathology Dentistry	C0722	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922166362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT O GREER DDS

Provider Business Mailing Address
First Line	:	PO BOX 327
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80038-0327
Country	:	US
Telephone Number	:	303-657-2763
Fax Number	:	303-657-9023

Provider Business Practice Location Address
First Line	:	1999 N FITSIMONS PKWY
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-0000
Country	:	US
Telephone Number	:	303-577-2309
Fax Number	:	303-577-2302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/26/2012

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