DR. Ted Gordon Greenlee, D.D.S.

NPI #1861550287 in Loves Park, Illinois

Provider Information

NPI Number: 1861550287
Entity Type: Individual
Name: DR. Ted Gordon Greenlee, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Dec 5, 2006
Last Updated: Sep 11, 2025

Practice Location

Address: 2028 E RIVERSIDE BLVD
Address 2: SUITE 200
City: Loves Park
State: Illinois
ZIP Code: 61111-4804
Phone: (815) 282-5300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary
Dentist - General Practice — General Practice	1223G0001X

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