Provider Demographics
NPI:1982797981
Name:GREENWICH DENTAL CARE
Entity Type:Organization
Organization Name:GREENWICH DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ILARDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-531-5595
Mailing Address - Street 1:235 GLENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-4148
Mailing Address - Country:US
Mailing Address - Phone:203-531-5595
Mailing Address - Fax:203-531-5663
Practice Address - Street 1:235 GLENVILLE RD
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-4148
Practice Address - Country:US
Practice Address - Phone:203-531-5595
Practice Address - Fax:203-531-5663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004706122300000X
CT006653122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty