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General NPI Number Information
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NPI Number | 1417699646
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Entity Type | Organization
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Legal Business Name | GREENBURG DENTAL GROUP, PC.
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Dates
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Enumeration Date | 04/08/2022
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 4418 VINELAND AVE STE 112
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City | TOLUCA LAKE
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State | CA
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Zip | 91602-2159
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Country | US
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Telephone | 818-578-3500
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Fax | 818-796-3322
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Provider Business Mailing Address
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Address Line | 4418 VINELAND AVE STE 112
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City | TOLUCA LAKE
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State | CA
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Zip | 91602-2159
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Country | US
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Telephone | 818-578-3500
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Fax | 818-796-3322
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LIZ DUENAS
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Credential |
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Telephone | 818-578-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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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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