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General NPI Number Information
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NPI Number | 1194997452
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Entity Type | Organization
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Legal Business Name | MARSHALL S. GREENBERG, D.M.D., P.C.
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 201 DIVISION ST
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City | ANSONIA
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State | CT
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Zip | 06401-1138
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Country | US
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Telephone | 203-735-9600
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Fax | 203-954-0014
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Provider Business Mailing Address
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Address Line | 201 DIVISION ST
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City | ANSONIA
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State | CT
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Zip | 06401-1138
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Country | US
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Telephone | 203-735-9600
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Fax | 203-954-0014
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MARSHALL S. GREENBERG
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Credential | D.M.D.
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Telephone | 203-735-9600
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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 | 3900
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License Number State | CT
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