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Individual

DR. AMBER JENKINS GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
8200 MALL PKWY STE 155, LITHONIA, GA 30038-6985
(770) 484-4051
Mailing address
8200 MALL PKWY, SUITE #155, LITHONIA, GA 30038-6983
(770) 484-4051

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012419
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000945843D
GA
Enumeration date
10/17/2006
Last updated
07/13/2022
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