Individual
DR. JON TYLER GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
USA DENTAL HEALTH ACTIVITY, 652 HAMILTON RD., FT. SILL, OK 73503
(580) 442-3905
Mailing address
USA DENTAL HEALTH ACTIVITY, 652 HAMILTON RD., FT. SILL, OK 73503
(580) 442-3905
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5147
ID
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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