Provider Demographics
NPI:1194997155
Name:JOSEPH M GREENE JR DDS PC
Entity type:Organization
Organization Name:JOSEPH M GREENE JR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-433-0075
Mailing Address - Street 1:119 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE C VALLEY PROFESSIONAL COMMONS
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3753
Mailing Address - Country:US
Mailing Address - Phone:540-433-0075
Mailing Address - Fax:540-574-4549
Practice Address - Street 1:119 UNIVERSITY BLVD
Practice Address - Street 2:SUITE C VALLEY PROFESSIONAL COMMONS
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3753
Practice Address - Country:US
Practice Address - Phone:540-433-0075
Practice Address - Fax:540-574-4549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010046411223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
88132OtherUNITED CONCORDIA
265281OtherANTHEM