Organization
ORAL & MAXILLOFACIAL SURGERY OF ABILENE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN GREEN DDS, MD (PRESIDENT)
(325) 232-8939
Entity
Organization
Contact information
Practice address
1904 PINE ST STE 1D, ABILENE, TX 79601-2450
(325) 232-8939
(325) 232-8943
Mailing address
1904 PINE ST STE 1D, ABILENE, TX 79601-2450
(325) 232-8939
(325) 232-8943
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
24237
TX
174400000X
Specialist
N4439
TX
208600000X
Surgery Physician
N4439
TX
Other
Enumeration date
03/01/2013
Last updated
03/01/2013
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