Healthcare Provider Details

I. General information

NPI: 1457571564
Provider Name (Legal Business Name): DANIEL GREENSTEIN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 02/23/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8409 SW 80TH ST STE 15
OCALA FL
34481-9117
US

IV. Provider business mailing address

2930 NW 25TH TER
BOCA RATON FL
33434-3668
US

V. Phone/Fax

Practice location:
  • Phone: 352-414-1922
  • Fax:
Mailing address:
  • Phone: 561-620-2889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN9615
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: