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Individual

ZACHERY K GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
125 COUNTY ROAD 250, DURANGO, CO 81301-8530
(970) 247-0682
Mailing address
125 COUNTY ROAD 250, DURANGO, CO 81301-8530
(970) 247-0682
(970) 247-0682

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1511
WY
1223G0001X
General Practice Dentistry
Primary
#1151
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
124331400
WY
Enumeration date
01/30/2007
Last updated
09/30/2021
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