Provider Demographics
NPI:1811040579
Name:GREIN, GEORGE LEONARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:LEONARD
Last Name:GREIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 ABBOTT RD STE 120
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1956
Mailing Address - Country:US
Mailing Address - Phone:517-351-9540
Mailing Address - Fax:517-351-1645
Practice Address - Street 1:1500 ABBOTT RD STE 120
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1956
Practice Address - Country:US
Practice Address - Phone:517-351-9540
Practice Address - Fax:517-351-1645
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010089901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice