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Individual

MISS SADIE M GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DHAT

Contact information

Practice address
528 CHIEF EDDIE HOFFMAN HWY, BETHEL, AK 99559-0304
(907) 545-9022
Mailing address
PO BOX 304, HOOPER BAY, AK 99604-0304
(907) 545-9022

Taxonomy

Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
16-136-DHAT
AK

Other

Enumeration date
09/01/2016
Last updated
09/01/2016
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