DR. Shannon Dale Green, DMD

NPI #1205914595 in Cullman, Alabama

Provider Information

NPI Number: 1205914595
Entity Type: Individual
Name: DR. Shannon Dale Green, DMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Nov 2, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 322 GRAHAM ST SW
City: Cullman
State: Alabama
ZIP Code: 35055-5238
Phone: (256) 734-1656

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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