Provider Demographics
NPI:1417175332
Name:GREENE, RONALD J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:GREENE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 N MONROE DR
Mailing Address - Street 2:101
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-6609
Mailing Address - Country:US
Mailing Address - Phone:937-376-2441
Mailing Address - Fax:937-376-2441
Practice Address - Street 1:1237 N MONROE DR
Practice Address - Street 2:101
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-6609
Practice Address - Country:US
Practice Address - Phone:937-376-2441
Practice Address - Fax:937-376-2441
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14296122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist