Individual
DR. JOHN MARSHALL GREEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS FACS
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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