Individual
MARTIN P. GREENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1562 WELLS RD STE 16, ORANGE PARK, FL 32073-1723
(904) 644-0140
Mailing address
926 GREAT POND DR, SUITE 2002, ALTAMONTE SPRINGS, FL 32714-7244
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN18788
FL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN18788
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105162100
—
FL
Enumeration date
07/01/2009
Last updated
11/13/2020
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