Individual
DR. AMANDA S. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
763 E. MAIN STREET, SPARTANBURG, SC 29302
(864) 585-8558
(864) 580-4242
Mailing address
763 E. MAIN STREET, SPARTANBURG, SC 29302
(864) 585-8558
(864) 580-4242
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3703
SC
1223G0001X
General Practice Dentistry
SC 3703
SC
1223P0221X
Pediatric Dentistry
738PD
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9313
—
SC
05
—
ZA9481
—
SC
05
—
ZX3703
—
SC
Enumeration date
03/29/2007
Last updated
01/31/2024
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