Individual
DR. SHANNON GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4955 S PEORIA AVE, TULSA, OK 74105-4629
(918) 895-6568
Mailing address
112 SQUIRE HALL, BUFFALO, NY 14214-8006
(716) 829-6230
(716) 829-6230
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
247
OK
Other
Enumeration date
04/15/2019
Last updated
07/16/2024
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