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General NPI Number Information
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NPI Number | 1124153903
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Entity Type | Organization
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Legal Business Name | MICHAEL M. GREENWALD DDS PC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 160 ROBBINS ST 2ND FLOOR
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City | WATERBURY
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State | CT
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Zip | 06708-2652
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Country | US
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Telephone | 203-757-8855
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Fax | 203-757-0550
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Provider Business Mailing Address
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Address Line | 160 ROBBINS ST 2ND FLOOR
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City | WATERBURY
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State | CT
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Zip | 06708-2652
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Country | US
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Telephone | 203-757-8855
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Fax | 203-757-0550
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL M. GREENWALD
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Credential | D.D.S.
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Telephone | 203-757-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7481
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License Number State | CT
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