Individual
DR. JOHN MARSHALL GREEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS FACS
Contact information
Practice address
895 E WASHINGTON AVE, VINTON, VA 24179-2105
(540) 344-7252
Mailing address
703 THIMBLE SHOALS BLVD STE B-3, NEWPORT NEWS, VA 23606-4533
(757) 223-5800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6055
LA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0438000357
VA
Other
Enumeration date
09/24/2010
Last updated
01/28/2022
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