Most Relevant Information
Provider Data
| NPI Number: | 1003646480 |
| Provider Name: | HENRY GREEN DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 29483 |
Most Important Dates
| Enumeration Date: | 08/01/2024 |
| Last Updated: | 08/01/2024 |
Provider Practice Location
1986 STATE ROAD 19
TAVARES
FL
327784236
Practice Location Phone/Fax
| Phone: | 3527443190 |
| Fax: |
Provider Mailing Location
1986 STATE ROAD 19
TAVARES
FL
327784236
Provider Mailing Phone/Fax
| Phone: | 3527443190 |
| Fax: |