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Individual

JERRY CHARLES GREENFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
32105 1ST AVE S, B-5, FEDERAL WAY, WA 98003-5719
(253) 838-2055
(253) 874-2992
Mailing address
32105 1ST AVE S, B-5, FEDERAL WAY, WA 98003-5719
(253) 838-2055
(253) 874-2992

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00004214
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5744305
WA
Enumeration date
11/15/2006
Last updated
07/08/2007
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