Provider Demographics
NPI:1467808378
Name:GREENBRIAR DENTAL CARE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:GREENBRIAR DENTAL CARE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-344-5000
Mailing Address - Street 1:2841 GREENBRIAR PKWY SW STE X306
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-2635
Mailing Address - Country:US
Mailing Address - Phone:404-344-5000
Mailing Address - Fax:
Practice Address - Street 1:2841 GREENBRIAR PKWY SW STE X306
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2635
Practice Address - Country:US
Practice Address - Phone:404-344-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13689261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental