Provider Demographics
NPI:1922166362
Name:GREER, ROBERT O (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:O
Last Name:GREER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:O
Other - Last Name:GREER
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:D D S, SC D
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80038-0327
Mailing Address - Country:US
Mailing Address - Phone:303-657-2763
Mailing Address - Fax:303-657-9023
Practice Address - Street 1:1999 N FITSIMONS PKWY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-0000
Practice Address - Country:US
Practice Address - Phone:303-577-2309
Practice Address - Fax:303-577-2302
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC07221223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08678138Medicaid
COC67813Medicare PIN