# GERALD C. GREEN, DMD, PC

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

## Provider details

- **NPI number:** 1104588490
- **Authorized official:** MRS. AURORA A GREEN (MANAGER)
- **Authorized official phone:** (717) 299-5544

## Contact information

- **Practice address:** 2207 OREGON PIKE STE 201, LANCASTER, PA 17601-4670
- **Practice address phone:** (717) 299-5544
- **Mailing address:** 2207 OREGON PIKE STE 201, LANCASTER, PA 17601-4670
- **Mailing address phone:** (717) 299-5544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/13/2021
- **Last updated:** 10/13/2021