Organization
ANTHONY T.R. GREEN D.D.S.P.C.
Active
Other names
Anthony Green D.D.S.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY T.R. GREEN D.D.S.O.M.F.S. (ORAL SURGEON/OWNER)
(718) 739-1300
Entity
Organization
Contact information
Practice address
17836 WEXFORD TER, SUITE 2E, JAMAICA, NY 11432-3024
(718) 739-1300
(718) 739-0966
Mailing address
17836 WEXFORD TER, SUITE 2E, JAMAICA, NY 11432-3024
(718) 739-1300
(718) 739-0966
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02166558
—
NY
Enumeration date
07/09/2008
Last updated
07/09/2008
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