Individual
DENA A GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 S DOBSON RD, MESA, AZ 85202-4707
(480) 412-4204
Mailing address
1487 S COLT DR, GILBERT, AZ 85296-7341
(608) 201-9191
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
40325-20
WI
207RH0003X
Hematology & Oncology Physician
40325
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740370519
BCBSWI
WI
05
—
1740370519
—
WI
01
—
GREENDEN
MERCYCARE INSURANCE
WI
01
—
K400416358-000054176
WI MEDICARE
WI
Enumeration date
10/13/2006
Last updated
06/01/2022
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