Provider Demographics
NPI:1194947044
Name:GREENDALE, JOANNE MARIE (RDH)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:MARIE
Last Name:GREENDALE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 ARBORSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-8670
Mailing Address - Country:US
Mailing Address - Phone:972-412-4698
Mailing Address - Fax:
Practice Address - Street 1:2301 FOREST LN
Practice Address - Street 2:SUITE 103
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7954
Practice Address - Country:US
Practice Address - Phone:972-272-2564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13899124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist