Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 034015 | NY |
NPI | 1003895186 |
---|---|
Provider Name | Dr. David Mitchell Greene |
First Address | Scarsdale, NY 10583-5063 |
Second Address | Scarsdale, NY 10583-5063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 08/07/2007 |