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General NPI Number Information
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NPI Number | 1437369972
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Entity Type | Organization
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Legal Business Name | HARRY N GREEN III D.D.S. PLLC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10850 LOUETTA RD. SUITE 800
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City | HOUSTON
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State | TX
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Zip | 77070
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Country | US
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Telephone | 623-640-1153
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Fax |
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Provider Business Mailing Address
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Address Line | 12407 BRAZOS BEND TRL
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City | HUMBLE
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State | TX
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Zip | 77346-3481
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | HARRY N GREEN III
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Credential | D.D.S.
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Telephone | 623-640-1153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22057
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License Number State | TX
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