Individual
DR. LANCE DAVID GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1225 WILLOW CREEK RD, PRESCOTT, AZ 86301
(928) 445-5692
(925) 445-5313
Mailing address
1225 WILLOW CREEK RD, PRESCOTT, AZ 86301
(928) 445-5692
(925) 445-5313
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEA#BG202645
AZ
Other
Enumeration date
04/05/2006
Last updated
05/22/2013
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