| G.gary Green Dmd, Pa Inc | |
|
277 Bloomfield Ave Caldwell NJ 07006-5104 | |
| (973) 228-0252 | |
| (973) 228-0918 |
| Full Name | G.gary Green Dmd, Pa Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 277 Bloomfield Ave, Caldwell, New Jersey |
| Authorized Official Name and Position | Gail Gary Green (PERESIDENT/OWNER) |
| Authorized Official Contact | 9732280252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| G.gary Green Dmd, Pa Inc 277 Bloomfield Ave Caldwell NJ 07006-5104 Ph: (973) 228-0252 | G.gary Green Dmd, Pa Inc 277 Bloomfield Ave Caldwell NJ 07006-5104 Ph: (973) 228-0252 |
| NPI Number | 1912427295 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 3779856455 |
|---|---|
| Medicare Enrollment ID | O20170831000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912427295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 12168 (New Jersey) | Primary |
| Provider Name | Gail Green |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1609095827 PECOS PAC ID: 4688947369 Enrollment ID: I20170831000064 |
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