Provider Demographics
NPI:1639691462
Name:GREENE, MARGARET S (DDS)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:S
Last Name:GREENE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:MADISON
Other - Last Name:SPACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2441 21ST ST
Mailing Address - Street 2:
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-5582
Mailing Address - Country:US
Mailing Address - Phone:270-798-5429
Mailing Address - Fax:
Practice Address - Street 1:USA DENTAL HEALTH ACTIVITY FORT BRAGG
Practice Address - Street 2:WAMC BOX #151 2817 RIELLY RD
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310
Practice Address - Country:US
Practice Address - Phone:910-396-2607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16393122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist