Individual
JASON GREENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
440 NARRAGANSETT TRL, BUXTON, ME 04093-6505
(207) 352-4163
Mailing address
47 MILLIKEN ST APT 10, OLD ORCHARD BEACH, ME 04064-2318
(201) 705-7257
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN4857
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/25/2020
Last updated
07/07/2021
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