NPI 1760831457

Lisa Green, DENTALASSISTANTEFDA

Practitioner Dental Assistant Fort Drum, NY

Practice location

Address: 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005
Phone: (315) 772-6234

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X

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Registry record

NPI: 1760831457
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Jun 2016
Record last updated: 3 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.