Individual
JAMES A GREEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 TWO NOTCH RD, COLUMBIA, SC 29204-2822
(803) 691-9930
Mailing address
415 N GRAND AVE, PUEBLO, CO 81003-3111
(719) 562-4461
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4339
SC
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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