Individual
KRISTEN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
242 W CLINTON ST, GRAY, GA 31032-5430
(478) 986-6821
Mailing address
212 CHATHAM RD, AUGUSTA, GA 30907-3708
(478) 494-0324
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015669
GA
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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