Provider Demographics
NPI:1417291907
Name:DENTAL ANESTHESIA ASSOCIATES OF GREENVILLE, LLC
Entity Type:Organization
Organization Name:DENTAL ANESTHESIA ASSOCIATES OF GREENVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENI
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:864-552-1126
Mailing Address - Street 1:2131 WOODRUFF RD.
Mailing Address - Street 2:SUITE2100 #318
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2131 WOODRUFF RD.
Practice Address - Street 2:SUITE2100 #318
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681
Practice Address - Country:US
Practice Address - Phone:864-552-1126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTAL ANESTHESIA ASSOCIATES OF GREENVILLE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4447174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty