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General NPI Number Information
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NPI Number | 1720475569
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Entity Type | Individual
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Provider Name | RONALD GREENWALD
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Gender | Male
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 1134 N ROLLING RD
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City | BALTIMORE
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State | MD
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Zip | 21228-3931
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Country | US
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Telephone | 410-744-0260
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Fax |
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Provider Business Mailing Address
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Address Line | 22 WOODCHESTER CT
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City | BALTIMORE
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State | MD
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Zip | 21208-6382
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Country | US
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Telephone | 410-653-7454
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6125
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License Number State | MD
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