Eric Green, DDS
Dentist, General Practice in Childress, TX. Organization (NPI-2).
NPI number1154580397
StatusActive
Last updated in NPPESJun 3, 2008
Details
- NPI
- 1154580397
- Entity type
- Organization (NPI-2)
- Legal business name
- Eric Green, DDS
- Organization subpart
- No
- Enumeration date
- Jun 3, 2008
- Last updated
- Jun 3, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 23425 | TX | Yes |
Practice location
910 Oak LnChildress, TX 79201-2210
Phone 940-937-2248 · Fax 940-937-8260
Mailing address
Po Box 248Childress, TX 79201-0248
Phone 940-937-2248 · Fax 940-937-8260
Authorized official
Eric Coleman Green
Owner
9409372248
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