Individual
LANA S GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
307 W GABRIEL ST, ADVANCE, MO 63730-8301
(573) 722-3034
(573) 722-3244
Mailing address
307 W GABRIEL ST, ADVANCE, MO 63730-8301
(573) 722-3034
(573) 722-3244
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
002249
MO
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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