# RALPH M. GREEN MEDICAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023510518
- **Authorized official:** LEWIS C. JONES DMD, MD (PROVIDER)
- **Authorized official phone:** (502) 459-4273

## Contact information

- **Practice address:** 3809 POPLAR LEVEL RD STE B, LOUISVILLE, KY 40213-1429
- **Practice address phone:** (502) 459-4273
- **Practice address fax:** (502) 459-4343
- **Mailing address:** 3809 POPLAR LEVEL RD STE B, LOUISVILLE, KY 40213-1429
- **Mailing address phone:** (502) 459-4273
- **Mailing address fax:** (502) 459-4343

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 03/01/2018
- **Last updated:** 03/01/2018