Individual
BRAD GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2421 N CENTER ST STE D, FAYETTEVILLE, AR 72701-9609
(479) 445-7281
Mailing address
PO BOX 293, ELKINS, AR 72727-0293
(479) 445-6919
(479) 445-6920
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3578
AR
Other
Enumeration date
03/01/2007
Last updated
04/26/2023
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