Individual provider · Type 1 NPI
James Russell Green Iv, DMD
Oral and Maxillofacial Surgery (Dentist) · Tampa, FL
NPI number
1396970653
Active
Practice location
1309 W Fletcher Ave
Tampa, FL 33612
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | P64379 (NY) |
| Student in an Organized Health Care Education/Training Program | 390200000X | P64379 (NY) |
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 18270 (FL) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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About NPI 1396970653
James Russell Green Iv, DMD's National Provider Identifier is 1396970653, issued on May 15, 2009. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Tampa, FL. The record was last updated on Mar 27, 2018.