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General NPI Number Information
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NPI Number | 1821026576
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Entity Type | Organization
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Legal Business Name | GREENBERG DENTAL & ORTHODONTICS PA
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 926 GREAT POND DR STE 2003
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7244
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Country | US
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Telephone | 407-788-6533
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Fax |
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Provider Business Mailing Address
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Address Line | 926 GREAT POND DR STE 2003
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7244
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | TERRI GARDINER
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Credential |
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Telephone | 407-772-5124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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