Provider Demographics
NPI:1275210122
Name:JOHN C GREIF DDS MSD LLC
Entity Type:Organization
Organization Name:JOHN C GREIF DDS MSD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GREIF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:812-459-1031
Mailing Address - Street 1:1212 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-8002
Mailing Address - Country:US
Mailing Address - Phone:812-477-6112
Mailing Address - Fax:812-477-3510
Practice Address - Street 1:1212 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-8002
Practice Address - Country:US
Practice Address - Phone:812-477-6112
Practice Address - Fax:812-477-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty