Individual
LUKE NATHANIEL GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
MSC 06 3500, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131
(505) 925-4031
(505) 925-4030
Mailing address
MSC 06 3500, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 925-4031
(505) 925-4030
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN-DEN-LIC-15398
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
03/07/2017
Last updated
06/13/2018
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