Individual
DR. KACIE CROWELL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8900 WALNUT ST # 459, ROCKFORD, MN 55373-5135
(763) 477-5794
Mailing address
3480 211TH AVE NW, OAK GROVE, MN 55303-8802
(612) 716-7894
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14421
MN
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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