Individual
DR. DANIELLE ERNESTINE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
155 CALLE PORTAL STE 300, SIERRA VISTA, AZ 85635-2900
(520) 459-3011
Mailing address
155 CALLE PORTAL, SUITE 300, SIERRA VISTA, AZ 85635-2900
(520) 459-3011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D010341
AZ
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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