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General NPI Number Information
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NPI Number | 1780866996
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Entity Type | Organization
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Legal Business Name | JEFFREY GREENHILL, D.D.S.PA
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 12377 S CLEVELAND AVE SUITE #17
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City | FORT MYERS
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State | FL
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Zip | 33907-3899
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Country | US
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Telephone | 239-936-4757
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Fax | 239-936-0971
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Provider Business Mailing Address
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Address Line | 12377 S CLEVELAND AVE SUITE #17
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City | FORT MYERS
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State | FL
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Zip | 33907-3899
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Country | US
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Telephone | 239-936-4757
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Fax | 239-936-0971
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JEFFREY M. GREENHILL
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Credential | D.D.S.
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Telephone | 239-936-4757
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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 | DN10058
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License Number State | FL
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