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General NPI Number Information
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NPI Number | 1922440718
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Entity Type | Organization
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Legal Business Name | GREENE DENTISTRY P.C.
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 5810 GREENE ST STE 6
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City | PHILADELPHIA
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State | PA
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Zip | 19144-2761
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Country | US
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Telephone | 267-265-1751
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 RED LION RD
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1108
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Country | US
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Telephone | 267-265-1751
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HANI ELMIMEH
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Credential | DMD
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Telephone | 267-265-1751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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