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Organization

GREEN DENTISTRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN GREEN DMD (OWNER)
(801) 648-3653
Entity
Organization

Contact information

Practice address
707 24TH ST, STE 2A, OGDEN, UT 84401-2580
(801) 648-3653
Mailing address
5029 S 1200 E, OGDEN, UT 84403-4297
(801) 648-3653

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7692415-9922
UT

Other

Enumeration date
12/04/2016
Last updated
12/04/2016
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