Individual
DR. MEAGAN BROOKE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5005 MAIN ST APT 636, TACOMA, WA 98407-3163
(580) 382-1602
Mailing address
JBLM DENTAC BLDG 9900 2ND FLOOR, TACOMA, WA 98431-0001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7419
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7419
US ARMY
OK
Enumeration date
09/20/2021
Last updated
09/20/2021
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