Provider Demographics
NPI:1639134745
Name:TODD A GREESON DDS AND C LYNN LEWIS DDS PA
Entity Type:Organization
Organization Name:TODD A GREESON DDS AND C LYNN LEWIS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-227-2706
Mailing Address - Street 1:306B ALAMANCE RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:306B ALAMANCE RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5528
Practice Address - Country:US
Practice Address - Phone:336-227-2706
Practice Address - Fax:336-229-6809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty