Individual
MR. BRENTON MICHAEL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7000
Mailing address
3421 BUTTERFIELD DR, BISMARCK, ND 58503-8061
(218) 230-8214
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0858
ND
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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