# THE GREENAWALT DHALIWAL LLP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE GREENAWALT DHALIWAL LLP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255082632
- **Legal business name:** THE GREENAWALT DHALIWAL LLP
- **Authorized official:** DR. PAUL GREENAWALT DDS (PARTNER/OWNER/ORAL SURGEON)
- **Authorized official phone:** (360) 698-9335

## Contact information

- **Practice address:** 450 S KITSAP BLVD., STE 220, PORT PRCHARD, WA 98366
- **Practice address phone:** (360) 447-5100
- **Mailing address:** PO BOX 3770, SILVERDALE, WA 98383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | — |

## Other

- **Enumeration date:** 01/17/2022
- **Last updated:** 01/17/2022