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General NPI Number Information
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NPI Number | 1952748139
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Entity Type | Individual
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Provider Name | JESSICA LAUREN GREENWOOD D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/29/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 3818 N ELM ST SUITE A
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City | GREENSBORO
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State | NC
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Zip | 27455-2777
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Country | US
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Telephone | 336-286-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 2340 ROCKLAND CIR
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City | HIGH POINT
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State | NC
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Zip | 27265-9461
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Country | US
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Telephone | 336-254-7803
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 9489
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License Number State | NC
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