Provider Demographics
NPI:1093881930
Name:CORBIN-GREER & GREER, PSC
Entity Type:Organization
Organization Name:CORBIN-GREER & GREER, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:606-523-1961
Mailing Address - Street 1:1200 MASTER ST
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2502
Mailing Address - Country:US
Mailing Address - Phone:606-523-1961
Mailing Address - Fax:606-523-1978
Practice Address - Street 1:1200 MASTER ST
Practice Address - Street 2:SUITE1
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2502
Practice Address - Country:US
Practice Address - Phone:606-523-1961
Practice Address - Fax:606-523-1978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY48621223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty