Individual
DR. KENNETH ROBERT GREENBAUM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
2450 LANCASTER DR NE, SUITE 200, SALEM, OR 97305-1130
(503) 362-9548
(503) 362-2189
Mailing address
34 NORTHVIEW CT, LAKE OSWEGO, OR 97035-1072
(503) 699-7758
(503) 699-1194
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4701
OR
Other
Enumeration date
11/22/2005
Last updated
07/08/2007
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