Provider Demographics
NPI:1649399593
Name:GREENWOOD DENTAL ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:GREENWOOD DENTAL ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST-SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:NESS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-244-9000
Mailing Address - Street 1:609 W GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60087-5000
Mailing Address - Country:US
Mailing Address - Phone:847-244-9000
Mailing Address - Fax:847-244-0009
Practice Address - Street 1:609 W GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60087-5000
Practice Address - Country:US
Practice Address - Phone:847-244-9000
Practice Address - Fax:847-244-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty