Provider Demographics
NPI:1225241367
Name:GRECO, VICTOR STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:STEVEN
Last Name:GRECO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9930 JOHNNYCAKE RIDGE RD
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6752
Mailing Address - Country:US
Mailing Address - Phone:440-352-8828
Mailing Address - Fax:440-352-6265
Practice Address - Street 1:9930 JOHNNYCAKE RIDGE RD
Practice Address - Street 2:SUITE 1D
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6752
Practice Address - Country:US
Practice Address - Phone:440-352-8828
Practice Address - Fax:440-352-6265
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH180221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice