Provider Demographics
NPI:1144983792
Name:GREENWOOD DENTAL HUDSON, PLLC
Entity type:Organization
Organization Name:GREENWOOD DENTAL HUDSON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SLAVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELREHIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-821-9290
Mailing Address - Street 1:8 FLAGSTONE DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-4912
Mailing Address - Country:US
Mailing Address - Phone:978-390-1968
Mailing Address - Fax:
Practice Address - Street 1:8 FLAGSTONE DR UNIT C
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4912
Practice Address - Country:US
Practice Address - Phone:978-390-1968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty