Provider Demographics
NPI:1689848087
Name:DRS. GREINER, VISGER DENTAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:DRS. GREINER, VISGER DENTAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-255-2600
Mailing Address - Street 1:7553 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6001
Mailing Address - Country:US
Mailing Address - Phone:440-255-2600
Mailing Address - Fax:440-255-0162
Practice Address - Street 1:7553 CENTER ST
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6001
Practice Address - Country:US
Practice Address - Phone:440-255-2600
Practice Address - Fax:440-255-0162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherTAX ID NUMBER