# LESLIE J GREEN DMD LLC

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

## Provider details

- **NPI number:** 1598105371
- **Authorized official:** DR. LESLIE J GREEN DMD (OWNER)
- **Authorized official phone:** (610) 337-0950

## Contact information

- **Practice address:** 860 FIRST AVE, SUITE 6A, KING OF PRUSSIA, PA 19406-4033
- **Practice address phone:** (610) 337-0950
- **Practice address fax:** (610) 265-3560
- **Mailing address:** 860 FIRST AVE, SUITE 6A, KING OF PRUSSIA, PA 19406-4033
- **Mailing address phone:** (610) 337-0950
- **Mailing address fax:** (610) 265-3560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS18089L | PA | Yes |

## Other

- **Enumeration date:** 06/26/2013
- **Last updated:** 06/26/2013