Organization
ERIN GREEN DDS PC
Active
Other names
Grants Ferry Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIN GREEN DDS (OWNER)
(601) 850-2145
Entity
Organization
Contact information
Practice address
1075 LAKE VILLAGE CIR, BRANDON, MS 39047-6743
(601) 992-1605
Mailing address
1075 LAKE VILLAGE CIR, BRANDON, MS 39047-6743
(601) 850-2145
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669810040
NPI
LA
01
—
1699113365
NPI
MS
Enumeration date
06/24/2020
Last updated
06/24/2020
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