Provider Demographics
NPI:1386815223
Name:GREENWAY ORTHODONTICS LLC
Entity Type:Organization
Organization Name:GREENWAY ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANYADIKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-760-8888
Mailing Address - Street 1:30 GREENWAY ST NW
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3557
Mailing Address - Country:US
Mailing Address - Phone:410-760-8888
Mailing Address - Fax:410-760-8898
Practice Address - Street 1:30 GREENWAY ST NW
Practice Address - Street 2:SUITE 4
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3557
Practice Address - Country:US
Practice Address - Phone:410-760-8888
Practice Address - Fax:410-760-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty