Individual
DR. BRUCE GREGORY GREEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8901 WISCONSIN AVENUE, DEPARTMENT OF COMPREHENSIVE DENTISTRY, BETHESDA, MD 20889-0001
(301) 295-0145
(301) 295-0505
Mailing address
15438 FOREST OAK ST, PRAIRIEVILLE, LA 70769-4951
(504) 874-1309
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4353
LA
Other
Enumeration date
04/05/2006
Last updated
07/08/2007
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