Provider Demographics
NPI:1871800359
Name:GREENHALGH, DEL GRANT (DMD)
Entity type:Individual
Prefix:
First Name:DEL
Middle Name:GRANT
Last Name:GREENHALGH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10510 MONTWOOD DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-2703
Mailing Address - Country:US
Mailing Address - Phone:915-778-4681
Mailing Address - Fax:
Practice Address - Street 1:10510 MONTWOOD DR
Practice Address - Street 2:SUITE D
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-2703
Practice Address - Country:US
Practice Address - Phone:915-778-4681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0025959122300000X
FLDN19046122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist