# GREEN DENTAL

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

## Provider details

- **NPI number:** 1699128728
- **Authorized official:** TRISH NIERMAN (OFFICE MANAGER)
- **Authorized official phone:** (509) 662-8815

## Contact information

- **Practice address:** 1008 5TH ST, WENATCHEE, WA 98801-1823
- **Practice address phone:** (509) 662-8815
- **Practice address fax:** (509) 667-8725
- **Mailing address:** 1008 5TH ST, WENATCHEE, WA 98801-1823
- **Mailing address phone:** (509) 662-8815
- **Mailing address fax:** (509) 667-8725

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 60022722 | WA | Yes |

## Other

- **Enumeration date:** 07/13/2016
- **Last updated:** 07/13/2016