Individual
DENNIS JASON GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1050 REMOUNT RD, NORTH CHARLESTON, SC 29406-3544
(843) 743-7000
(843) 574-8212
Mailing address
1411 CROSS BILL TRL, HANAHAN, SC 29410-8231
(808) 989-0237
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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