DR. Ivan L Green

NPI #1053615831 in Roseville, Michigan

Provider Information

NPI Number
1053615831
Entity Type
Individual
Name
DR. Ivan L Green
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Enumeration Date
Jan 7, 2011
Last Updated
Jan 7, 2011

Practice Location

Address
19551 E 10 MILE RD
ZIP Code
48066-3998
Phone
(586) 775-6770

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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