Provider Demographics
NPI:1609010024
Name:GREENWOOD, COURTNEY ANTIONIO (DDS)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ANTIONIO
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:REBECCA
Other - Last Name:ANTONIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6911 PILLIOD RD.
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528
Mailing Address - Country:US
Mailing Address - Phone:734-272-2118
Mailing Address - Fax:419-867-0829
Practice Address - Street 1:5860 WEST ALEXIS RD.
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560
Practice Address - Country:US
Practice Address - Phone:419-882-7187
Practice Address - Fax:419-882-3165
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0229581223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry