Individual
DR. GORDON KEITH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
147 E BROAD ST, LYONS, IN 47443-9502
(812) 659-2111
(812) 659-2808
Mailing address
P O BOX 501, 147 EAST BROAD ST, LYONS, IN 47443-9502
(812) 659-2111
(812) 659-2808
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7342
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100124690A
—
IN
01
—
457474
UNITED CONCORDIA
IN
Enumeration date
07/17/2006
Last updated
12/17/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us