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General NPI Number Information
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NPI Number | 1467655548
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Entity Type | Organization
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Legal Business Name | THE GREENAWALT DHALIWAL LLP
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 19503 7TH AVE NE
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City | POULSBO
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State | WA
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Zip | 98370
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Country | US
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Telephone | 360-779-2339
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Fax | 360-779-6475
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Provider Business Mailing Address
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Address Line | PO BOX 3770
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City | SILVERDALE
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State | WA
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Zip | 98383
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Country | US
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Telephone | 360-698-9335
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Fax | 360-698-9385
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Authorized Official
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Title or Position | PARTNER
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Name | DR. PAUL B GREENAWAIT
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Credential | DDS
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Telephone | 360-698-9335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 8080
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State | WA
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