Individual
DR. LARRY PAUL GREEN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
102 N EGAN AVE, MADISON, SD 57042
(605) 256-4969
(605) 256-4717
Mailing address
PO BOX 243 102 N EGAN AVE, MADISON, SD 57042
(605) 256-4969
(605) 256-4717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
M594
SD
Other
Enumeration date
11/06/2006
Last updated
05/15/2023
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