Organization
DAVID GREEN DDS PA
Active
Other names
Premier Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA CAUWELS (ADM. ASSIST)
(561) 733-3361
Entity
Organization
Contact information
Practice address
11135 S JOG RD, SUITE 3, BOYNTON BEACH, FL 33437-1807
(561) 733-3361
(561) 733-8865
Mailing address
11135 S JOG RD, SUITE 3, BOYNTON BEACH, FL 33437-1807
(561) 733-3361
(561) 733-8865
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15023
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902991870
PPO'S
FL
Enumeration date
09/09/2013
Last updated
08/02/2016
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