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General NPI Number Information
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NPI Number | 1831530849
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Entity Type | Organization
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Legal Business Name | GREENWOOD DENTAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 07/08/2013
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 112 SPIT BROOK RD SUITE C
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City | NASHUA
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State | NH
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Zip | 03062
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Country | US
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Telephone | 978-390-1969
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Fax |
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Provider Business Mailing Address
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Address Line | 14 MOUNTAIN LAURELS DR UNIT 403
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City | NASHUA
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State | NH
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Zip | 03062-2370
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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 | PRESIDENT
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Name | DR. SLAVA ABDELREHIM
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Credential | DDS
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Telephone | 978-390-1969
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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 | 3314
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License Number State | NH
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