Provider Demographics
NPI:1568137495
Name:GREENHALGH, CHRISTINA PECHA
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:PECHA
Last Name:GREENHALGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 HAYDEN CREEK CT
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-7626
Mailing Address - Country:US
Mailing Address - Phone:502-689-3417
Mailing Address - Fax:
Practice Address - Street 1:10610 MEETING ST
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-6513
Practice Address - Country:US
Practice Address - Phone:502-339-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10684122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist