Provider Demographics
NPI:1871938290
Name:GREEN, JOANNA GRABIAK (DDS)
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:GRABIAK
Last Name:GREEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26670 CENTERVIEW DR
Mailing Address - Street 2:UNIT 19
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-3584
Mailing Address - Country:US
Mailing Address - Phone:302-297-3750
Mailing Address - Fax:
Practice Address - Street 1:26670 CENTERVIEW DR
Practice Address - Street 2:UNIT 19
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-3584
Practice Address - Country:US
Practice Address - Phone:302-297-3750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-0001339122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist