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General NPI Number Information
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NPI Number | 1306469184
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Entity Type | Organization
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Legal Business Name | MYA P. GREENBERG, D.M.D., L.L.C.
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 225 5TH ST NE
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City | CAIRO
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State | GA
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Zip | 39828-2233
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Country | US
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Telephone | 229-377-6125
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Fax | 229-377-5601
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Provider Business Mailing Address
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Address Line | 225 5TH ST NE
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City | CAIRO
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State | GA
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Zip | 39828-2233
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Country | US
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Telephone | 229-377-6125
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Fax | 229-377-5601
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Authorized Official
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Title or Position | OWNER
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Name | DR. MYA POPE GREENBERG
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Credential | D.M.D.
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Telephone | 229-377-6125
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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 |
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License Number State |
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