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Organization

EDWARD J GREEN DMD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD JAMES GREEN DOCTOR OF DENTAL MED (S CORP PRESIDENT)
(229) 883-3071
Entity
Organization

Contact information

Practice address
1505 W THIRD AVENUE, SUITE B, ALBANY, GA 31707-3647
(229) 883-3071
(229) 883-5184
Mailing address
PO BOX 70907, ALBANY, GA 31708-0907
(229) 883-3071
(229) 883-5184

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN09807
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00267044B
GA
Enumeration date
11/20/2006
Last updated
08/22/2020
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