Individual
DR. ERIN RUSSELL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
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
1223G0001X
General Practice Dentistry
Primary
3688-13
MS
Other
Enumeration date
06/04/2013
Last updated
06/19/2020
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