Individual
DR. SHANNON DALE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
322 GRAHAM ST SW, CULLMAN, AL 35055-5238
(256) 734-1656
(256) 734-1659
Mailing address
322 GRAHAM ST SW, CULLMAN, AL 35055-5238
(256) 734-1656
(256) 734-1659
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4785
AL
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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