Healthcare Provider Details

I. General information

NPI: 1922166362
Provider Name (Legal Business Name): ROBERT O GREER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROBERT O GREER JR. D D S, SC D

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1999 N FITSIMONS PKWY
AURORA CO
80045-0000
US

IV. Provider business mailing address

PO BOX 327
BROOMFIELD CO
80038-0327
US

V. Phone/Fax

Practice location:
  • Phone: 303-577-2309
  • Fax: 303-577-2302
Mailing address:
  • Phone: 303-657-2763
  • Fax: 303-657-9023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberC0722
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: