Individual
CHRISTOPHER LEE GREENWALDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6050 BRYNWOOD DR STE 205, ROCKFORD, IL 61114-6579
(815) 201-5955
Mailing address
1257 N ASHLAND AVE UNIT 206, CHICAGO, IL 60622-0399
(312) 607-8106
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
021.003451
IL
1223G0001X
General Practice Dentistry
019.030223
IL
1223G0001X
General Practice Dentistry
1001283-15
WI
Other
Enumeration date
04/26/2015
Last updated
06/24/2026
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