Individual
JASMINE EVANNA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1099 N MAIN ST STE 102, SUMMERVILLE, SC 29483-7300
(843) 536-8577
(843) 790-2602
Mailing address
107 UPCERNE RD, SUMMERVILLE, SC 29485-4075
(252) 904-8808
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10793
SC
Other
Enumeration date
04/19/2022
Last updated
07/19/2024
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