Individual
MICHAEL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6821 W 120TH AVE STE B, BROOMFIELD, CO 80020-2355
(303) 421-6165
Mailing address
6821 W 120TH AVE STE B, BROOMFIELD, CO 80020-2355
(303) 421-6165
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11397
TN
1223G0001X
General Practice Dentistry
Primary
DEN.00205927
CO
Other
Enumeration date
08/04/2020
Last updated
05/21/2026
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