JACK L GREEN

MYRTLE BEACH, SC
NPI1770608119
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: SC  1629)
Enumeration Date2007-03-21
Last Update Date2007-07-08
Business Address
Dr. JACK L GREEN DDS MSD
1201 48TH AVE N
MYRTLE BEACH, SC 29577-5432
Phone number: 843-449-1444
Mailing Address
Dr. JACK L GREEN DDS MSD
1201 48TH AVE N
MYRTLE BEACH, SC 29577-5432
Phone number: 843-449-1444
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