Provider Demographics
NPI:1073784187
Name:GREIG-MOORE, ELIZABETH CHARLOTTE (DDS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CHARLOTTE
Last Name:GREIG-MOORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:CHARLOTTE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1001 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5828
Mailing Address - Country:US
Mailing Address - Phone:410-848-8229
Mailing Address - Fax:410-848-4332
Practice Address - Street 1:1001 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5828
Practice Address - Country:US
Practice Address - Phone:410-848-8229
Practice Address - Fax:410-848-4332
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice