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General NPI Number Information
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NPI Number | 1659572972
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Entity Type | Organization
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Legal Business Name | R. KEVIN GREENWAY, D.D.S. RALPH N. GREENWAY, D.D.S., P.C.
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 614 EAST WASHINGTON AVENUE
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City | VINTON
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State | VA
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Zip | 24179
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Country | US
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Telephone | 540-342-2949
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Fax | 540-345-3919
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Provider Business Mailing Address
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Address Line | PO BOX 368
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City | VINTON
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State | VA
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Zip | 24179-0368
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Country | US
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Telephone | 540-342-2949
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Fax | 540-345-3919
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Authorized Official
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Title or Position | DENTIST
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Name | DR. R. KEVIN GREENWAY
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Credential | D.D.S
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Telephone | 540-342-2949
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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 | 0401007925
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License Number State | VA
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