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General NPI Number Information
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NPI Number | 1598340481
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Entity Type | Individual
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Provider Name | RENEE SHIRLEY GREENE DDS
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Gender | Female
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Dates
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Enumeration Date | 03/12/2021
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 1616 E 8TH ST
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City | ODESSA
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State | TX
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Zip | 79761-4807
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Country | US
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Telephone | 806-794-8124
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Fax |
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Provider Business Mailing Address
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Address Line | 16601 SIMONNE LN
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-4354
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Country | US
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Telephone | 714-469-6755
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 40926
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License Number State | TX
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