Provider Demographics
NPI:1558691857
Name:GREENE COMPREHENSIVE FAMILY DENTISTRY PLC
Entity Type:Organization
Organization Name:GREENE COMPREHENSIVE FAMILY DENTISTRY PLC
Other - Org Name:GREEN COMPREHENSIVE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHYNOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-985-1052
Mailing Address - Street 1:140 STONERIDGE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968-3096
Mailing Address - Country:US
Mailing Address - Phone:434-985-1052
Mailing Address - Fax:434-990-2066
Practice Address - Street 1:140 STONERIDGE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:RUCKERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22968-3096
Practice Address - Country:US
Practice Address - Phone:434-985-1052
Practice Address - Fax:434-990-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410523261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental