Provider Demographics
NPI:1104046986
Name:GREENHILLS FAMILY DENTISTRY, INC.
Entity type:Organization
Organization Name:GREENHILLS FAMILY DENTISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-825-2121
Mailing Address - Street 1:42 ESWIN STREET
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45218
Mailing Address - Country:US
Mailing Address - Phone:513-825-2121
Mailing Address - Fax:513-825-8084
Practice Address - Street 1:42 ESWIN STREET
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45218
Practice Address - Country:US
Practice Address - Phone:513-825-2121
Practice Address - Fax:513-825-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30020889122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty