Individual
DR. KRISTIN DYAN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2209 OAK RIDGE DR, NEOSHO, MO 64850-9092
(417) 451-0977
(417) 451-0977
Mailing address
PO BOX 758, NEOSHO, MO 64850-0758
(417) 451-9450
(417) 451-8903
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2014015540
MO
1223G0001X
General Practice Dentistry
3730
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180656608
—
AR
Enumeration date
07/01/2009
Last updated
10/25/2024
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