Organization
THOMAS H. GREENE DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLE F GREENE (V. PRES-BUSI. MGR.)
(304) 345-7402
Entity
Organization
Contact information
Practice address
1109 FLEDDERJOHN RD, CHARLESTON, WV 25314-4204
(304) 345-7402
(304) 345-7402
Mailing address
1109 FLEDDERJOHN RD, CHARLESTON, WV 25314-4204
(304) 345-7402
(304) 345-7402
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1596
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135218000
—
WV
01
—
464482
ANTHEM BLUE CROSS BLUE SH
WV
01
—
545343
UNITED CONCORDIA
WV
Enumeration date
11/18/2006
Last updated
08/22/2020
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