Individual
AUSTIN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4235 S OAK AVE, SPRINGFIELD, MO 65804-6664
(417) 830-2333
Mailing address
4235 S OAK AVE, SPRINGFIELD, MO 65804-6664
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
35926
TX
Other
Enumeration date
03/06/2021
Last updated
03/06/2021
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