Provider Demographics
NPI:1609880830
Name:GREENE, DAVID JONATHAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JONATHAN
Last Name:GREENE
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:39 SIMON ST
Mailing Address - Street 2:UNIT 11-13
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3046
Mailing Address - Country:US
Mailing Address - Phone:603-882-4008
Mailing Address - Fax:603-881-3822
Practice Address - Street 1:39 SIMON ST
Practice Address - Street 2:UNIT 11-13
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3046
Practice Address - Country:US
Practice Address - Phone:603-883-4008
Practice Address - Fax:603-881-3822
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH21921223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery