Individual
DR. CHARLES S GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
811 W WELLINGTON AVE, DEPT OF DENTISTRY - AIMMC, CHICAGO, IL 60657-5123
(773) 871-4964
Mailing address
1041 RIDGE RD, APT. 304, WILMETTE, IL 60091-1560
(847) 256-3999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
190-12322
IL
Other
Enumeration date
08/20/2006
Last updated
05/27/2009
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