| Randi Green D.m.d., Llc | |
|
2053 S Waverly Ave Ste E Springfield MO 65804-2497 | |
| (417) 887-5155 | |
| (417) 823-7497 |
| Full Name | Randi Green D.m.d., Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2053 S Waverly Ave Ste E, Springfield, Missouri |
| Authorized Official Name and Position | Randi C. Green (OWNER/ DENTIST) |
| Authorized Official Contact | 4178875155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randi Green D.m.d., Llc 2053 S Waverly Ave Ste E Springfield MO 65804-2497 Ph: (417) 887-5155 | Randi Green D.m.d., Llc 2053 S Waverly Ave Ste E Springfield MO 65804-2497 Ph: (417) 887-5155 |
| NPI Number | 1942592977 |
|---|---|
| Provider Enumeration Date | 05/10/2011 |
| Last Update Date | 05/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942592977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2011012315 (Missouri) | Primary |
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