Individual
DR. AUSTIN REVVIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7911 WOODWAY DR, WACO, TX 76712-3866
(254) 772-3632
Mailing address
7911 WOODWAY DR, WACO, TX 76712-3866
(254) 772-3632
(254) 772-7856
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
33131
TX
Other
Enumeration date
06/07/2017
Last updated
07/21/2022
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