# DR DANIEL M ETHERIDGE DDS LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Greenbrier Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003942012
- **Authorized official:** DR. DANIEL M ETHERIDGE DDS (PRESIDENT)
- **Authorized official phone:** (757) 547-2266

## Contact information

- **Practice address:** 1059 EDEN WAY N STE 100, CHESAPEAKE, VA 23320-2789
- **Practice address phone:** (757) 547-2266
- **Mailing address:** 1059 EDEN WAY N STE 100, CHESAPEAKE, VA 23320-2789
- **Mailing address phone:** (757) 547-2266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 08/22/2020