Provider Demographics
NPI:1255082632
Name:THE GREENAWALT DHALIWAL LLP
Entity type:Organization
Organization Name:THE GREENAWALT DHALIWAL LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER/ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENAWALT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-698-9335
Mailing Address - Street 1:PO BOX 3770
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 S KITSAP BLVD.
Practice Address - Street 2:STE 220
Practice Address - City:PORT PRCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366
Practice Address - Country:US
Practice Address - Phone:360-447-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE GREENAWALT DHALIWAL LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty