Individual
KIMBERLY SUSAN GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6350 W ANDREW JOHNSON HWY, TALBOTT, TN 37877-8605
(423) 587-7337
(423) 586-0614
Mailing address
6350 W ANDREW JOHNSON HWY DEPT 100, TALBOTT, TN 37877-8605
(800) 355-3565
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
21825
TN
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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