Individual
DR. DAVID LAWRENCE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2410 SAMSON ST., BLDG 237, GREAT LAKES, IL 60088
(509) 876-7270
Mailing address
1805 ARKANSAS AVE, GREAT LAKES, IL 60088-4244
(509) 876-7270
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2456
MT
122300000X
Dentist
Primary
DE 60223505
WA
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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