Provider Demographics
NPI:1295948826
Name:DRS GREENWALD RIGER KYSER & WANG
Entity type:Organization
Organization Name:DRS GREENWALD RIGER KYSER & WANG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWALD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PA
Authorized Official - Phone:410-418-8370
Mailing Address - Street 1:10045 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:SUITE A1
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042
Mailing Address - Country:US
Mailing Address - Phone:410-418-8370
Mailing Address - Fax:410-418-9068
Practice Address - Street 1:10045 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:SUITE A1
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:410-418-8370
Practice Address - Fax:410-418-9068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD61251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty