Organization
GREENE ENDODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN JOSEPH GREENE (OWNER)
(765) 649-1277
Entity
Organization
Contact information
Practice address
3811 FAIRVIEW DR, ANDERSON, IN 46013-4059
(765) 649-1277
(765) 357-9121
Mailing address
3811 FAIRVIEW DR, ANDERSON, IN 46013-4059
(765) 649-1277
(765) 357-9121
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300013383
—
IN
Enumeration date
01/17/2019
Last updated
01/17/2019
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