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NPI 1104380740

NPI 1104380740 : ALLISON GREENBERG DDS : AVON, CT

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General NPI Number Information
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    NPI Number           |    1104380740
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    Entity Type          |    Individual 
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    Provider Name        |    ALLISON GREENBERG DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/28/2019
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    Last Update Date     |    02/19/2026
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Provider Practice Location Address
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    Address Line         |    44 DALE RD 
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    City                 |    AVON
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    State                |    CT
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    Zip                  |    06001-4315
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    Country              |    US
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    Telephone            |    860-674-8417
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    44 DALE RD 
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    City                 |    AVON
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    State                |    CT
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    Zip                  |    06001-4315
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    Country              |    US
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    Telephone            |    860-674-8417
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    CT12435
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    License Number State |    CT
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