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Individual

DR. CHAZ DAJUAN GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
19815 MARVIN RD, CLEVELAND, OH 44128-4215
(216) 374-8354
Mailing address
19815 MARVIN RD, CLEVELAND, OH 44128-4215
(216) 374-8354

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2826
OH

Other

Enumeration date
06/10/2009
Last updated
06/10/2009
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