Individual
DR. MARK TYLER GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
30 WEST MEDICAL DRIVE, MONUMENT VALLEY, UT 84536
(713) 376-5004
Mailing address
PO BOX 360005, MONUMENT VALLEY, UT 84536-0005
(713) 376-5004
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27972
TX
122300000X
Dentist
Primary
8012613-9921
UT
Other
Enumeration date
06/30/2011
Last updated
09/19/2012
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