Provider Demographics
NPI:1053816207
Name:JEFFREY H. GREENSTEIN, D.D.S., P.A.
Entity type:Organization
Organization Name:JEFFREY H. GREENSTEIN, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:GREENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-437-3773
Mailing Address - Street 1:8651 FORT SMALLWOOD RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122
Mailing Address - Country:US
Mailing Address - Phone:410-437-3773
Mailing Address - Fax:410-437-5302
Practice Address - Street 1:8651 FORT SMALLWOOD RD
Practice Address - Street 2:SUITE 4
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122
Practice Address - Country:US
Practice Address - Phone:410-437-3773
Practice Address - Fax:410-437-5302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6410122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty