MEDICARE: LEIGH ANN GREER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6822	CO

General Provider Information

NPI Number	:	1134259971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGH ANN GREER DDS

Provider Business Mailing Address
First Line	:	320 E FONTANERO
Second Line	:	SUITE 302
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-7526
Country	:	US
Telephone Number	:	719-634-4803
Fax Number	:	719-634-3610

Provider Business Practice Location Address
First Line	:	320 E FONTANERO
Second Line	:	SUITE 302
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-7526
Country	:	US
Telephone Number	:	719-634-4803
Fax Number	:	719-634-3610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/08/2007

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