Provider Demographics
NPI:1063749133
Name:BARRY J. GREYSON DMD INC
Entity type:Organization
Organization Name:BARRY J. GREYSON DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GREYSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:1405-525-6882
Mailing Address - Street 1:2120 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-2402
Mailing Address - Country:US
Mailing Address - Phone:140-552-5688
Mailing Address - Fax:
Practice Address - Street 1:2120 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2402
Practice Address - Country:US
Practice Address - Phone:140-552-5688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental