# REEBYE PARK & RICHMAN DDS PLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** REEBYE PARK & RICHMAN DDS PLC
- **Other names:** Triangle Implant Center Greensboro
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104317163
- **Legal business name:** REEBYE PARK & RICHMAN DDS PLC
- **Authorized official:** ANDRES F HENAO (TECHNICAL DIRECTOR)
- **Authorized official phone:** (919) 563-2897

## Contact information

- **Practice address:** 200 E WENDOVER AVE, GREENSBORO, NC 27401
- **Practice address phone:** (336) 272-4583
- **Practice address fax:** (336) 542-5164
- **Mailing address:** 1107 S FIFTH ST STE 250, MEBANE, NC 27302-9896
- **Mailing address phone:** (919) 563-2897
- **Mailing address fax:** (919) 563-2876

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | 8976 | NC | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NC | Yes |

## Other

- **Enumeration date:** 05/25/2018
- **Last updated:** 03/09/2023