Organization
GREENE DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN EDWARD GREENE DDS (PRESIDENT)
(860) 889-8427
Entity
Organization
Contact information
Practice address
65 SACHEM ST, NORWICH, CT 06360-4201
(860) 889-8427
(860) 204-9402
Mailing address
65 SACHEM ST, NORWICH, CT 06360-4201
(860) 889-8427
(860) 204-9402
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
009537
CT
Other
Enumeration date
06/28/2007
Last updated
06/20/2014
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