Provider Demographics
NPI:1063431773
Name:GREINER, GREGORY HITCHCOCK (DMD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:HITCHCOCK
Last Name:GREINER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 712
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-0712
Mailing Address - Country:US
Mailing Address - Phone:803-684-2366
Mailing Address - Fax:803-684-9101
Practice Address - Street 1:333 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-1575
Practice Address - Country:US
Practice Address - Phone:803-684-2366
Practice Address - Fax:803-684-9101
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice