Provider Demographics
NPI:1740366830
Name:GREENWOOD, OLIVER C JR (DDS)
Entity type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:C
Last Name:GREENWOOD
Suffix:JR
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 1:8092 ELM DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1159
Mailing Address - Country:US
Mailing Address - Phone:804-746-0127
Mailing Address - Fax:804-746-0833
Practice Address - Street 1:8092 ELM DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1159
Practice Address - Country:US
Practice Address - Phone:804-746-0127
Practice Address - Fax:804-746-0833
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010059711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice