Provider Demographics
NPI:1063510006
Name:GREENE, EARLENE F (DMD)
Entity Type:Individual
Prefix:MRS
First Name:EARLENE
Middle Name:F
Last Name:GREENE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:EARLENE
Other - Middle Name:F
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:204 S 2ND ST STE 1
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1804
Mailing Address - Country:US
Mailing Address - Phone:859-236-1898
Mailing Address - Fax:859-236-2169
Practice Address - Street 1:201 WEST WALNUT STREET
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422
Practice Address - Country:US
Practice Address - Phone:859-236-1898
Practice Address - Fax:859-236-2169
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY59051223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics