Healthcare Provider Details

I. General information

NPI: 1265288179
Provider Name (Legal Business Name): GRETA H. ROHR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5709 ODANA RD
MADISON WI
53719-1238
US

IV. Provider business mailing address

4612 HAMMERSLEY RD APT 323
MADISON WI
53711-2787
US

V. Phone/Fax

Practice location:
  • Phone: 608-274-5970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6001560
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number6001560
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: