Individual
DR. ANTHONY TREVOR GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. D. S.
Contact information
Practice address
17836 WEXFORD TER, SUITE 2E, JAMAICA, NY 11432-3024
(718) 739-1300
(718) 739-0966
Mailing address
17836 WEXFORD TER, SUITE 2E, JAMAICA, NY 11432-3024
(718) 739-1300
(718) 739-0966
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0473299
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02166558
—
NY
Enumeration date
11/08/2005
Last updated
03/20/2014
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