Provider Demographics
NPI:1528735545
Name:GREENE COUNTY HEALTH DEPT. DENTAL
Entity type:Organization
Organization Name:GREENE COUNTY HEALTH DEPT. DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ARNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:334-206-7065
Mailing Address - Street 1:412 MORROW AVE
Mailing Address - Street 2:
Mailing Address - City:EUTAW
Mailing Address - State:AL
Mailing Address - Zip Code:35462-1109
Mailing Address - Country:US
Mailing Address - Phone:205-372-9361
Mailing Address - Fax:205-372-9283
Practice Address - Street 1:412 MORROW AVE
Practice Address - Street 2:
Practice Address - City:EUTAW
Practice Address - State:AL
Practice Address - Zip Code:35462-1109
Practice Address - Country:US
Practice Address - Phone:205-372-9361
Practice Address - Fax:205-372-9283
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALABAMA DEPARTMENT OF PUBLIC HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-26
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare