Provider Demographics
NPI:1316237621
Name:GRECO AESTHETICS LLC
Entity type:Organization
Organization Name:GRECO AESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:615-673-1319
Mailing Address - Street 1:2695 OLD WINDER HWY
Mailing Address - Street 2:STE 150
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-0000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2695 OLD WINDER HWY
Practice Address - Street 2:STE 150
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-0000
Practice Address - Country:US
Practice Address - Phone:615-673-1319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty