| Brad H. Green D.d.s., P.a. | |
|
2421 N Center St Suite D Fayetteville AR 72701-9455 | |
| (479) 445-6919 | |
| (479) 445-6929 |
| Full Name | Brad H. Green D.d.s., P.a. |
|---|---|
| Speciality | Dentist |
| Location | 2421 N Center St, Fayetteville, Arkansas |
| Authorized Official Name and Position | Brad Green (OWNER) |
| Authorized Official Contact | 4794457281 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brad H. Green D.d.s., P.a. 101 S Pittman St Prairie Grove AR 72753-3247 Ph: (479) 846-1005 | Brad H. Green D.d.s., P.a. 2421 N Center St Suite D Fayetteville AR 72701-9455 Ph: (479) 445-6919 |
| NPI Number | 1205175676 |
|---|---|
| Provider Enumeration Date | 02/05/2013 |
| Last Update Date | 02/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205175676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3578 (Arkansas) | Primary |
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