Individual
ELIZABETH MARIE GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
N2846 SHADOW RD, WAUPACA, WI 54981-9497
(715) 201-6739
Mailing address
N2846 SHADOW RD, WAUPACA, WI 54981-9497
(715) 201-6739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001115
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2022
Last updated
08/21/2023
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