Provider Demographics
NPI:1871623165
Name:GREENE, KATHLEEN JOANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:JOANNE
Last Name:GREENE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:1810 PROFESSIONAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2165
Mailing Address - Country:US
Mailing Address - Phone:916-485-6900
Mailing Address - Fax:916-485-0102
Practice Address - Street 1:1810 PROFESSIONAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2165
Practice Address - Country:US
Practice Address - Phone:916-485-6900
Practice Address - Fax:916-485-0102
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA358921223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics