Individual
KEVIN JEFFREY GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6420 COTTAGE GROVE RD, MADISON, WI 53718-6592
(608) 222-8080
Mailing address
6420 COTTAGE GROVE RD, MADISON, WI 53718-6592
(608) 222-8080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1001151-15
WI
122300000X
Dentist
Primary
6387
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2015
Last updated
04/06/2021
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