Individual
MS. LISA MARIE GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
15301 TYLER FOOTE RD, NEVADA CITY, CA 95959-9318
(530) 292-3478
Mailing address
578 SUTTON WAY, GRASS VALLEY, CA 95945-5390
(530) 277-6193
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
17894
CA
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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