Individual
DR. EDWARD J GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1505 W 3RD AVE, SUITE B, ALBANY, GA 31707-3647
(229) 883-3071
(229) 883-5184
Mailing address
1505 W 3RD AVE, SUITE B, ALBANY, GA 31707-3647
(229) 883-3071
(229) 883-5184
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9807
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00267044B
—
GA
Enumeration date
11/11/2008
Last updated
11/11/2008
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