Provider Demographics
NPI:1407968944
Name:GREENHALGH, SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:GREENHALGH
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 1:3190 S WADSWORTH BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-4800
Mailing Address - Country:US
Mailing Address - Phone:303-988-9060
Mailing Address - Fax:303-479-7599
Practice Address - Street 1:3190 S WADSWORTH BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-4800
Practice Address - Country:US
Practice Address - Phone:303-988-9060
Practice Address - Fax:303-479-7599
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO065651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice