Green, Amanda S.
Green, Amanda S. is an sole proprietor health care provider with primary practice located at 763 E. Main Street , Spartanburg SC 29302. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / General Practice is her primary health care specialty. Green, Amanda S. can be contacted via phone (864) 585-8558.Contact Information
Primary practice address
763 E. Main Street
Spartanburg SC 29302
Phone: (864) 585-8558
Fax: (864) 580-4242
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / General Practice | 1223G0001X | SC 3703 | South Carolina |
Dental Providers / Pediatric Dentistry | 1223P0221X | 738PD | South Carolina |
Dental Providers / General Practice | 1223G0001X | 3703 | South Carolina |
Profile Details
NPI number | 1588783344 |
---|---|
LBN Legal business name | Green, Amanda S. |
Credentials | Doctor of Dental Medicine (DMD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Mar 29th, 2007 |
Last updated | Jan 31st, 2024 - about 11 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1588783344 | NPPES |
South Carolina | MEDICAID | ZA9313 | |
South Carolina | MEDICAID | ZA9481 | |
South Carolina | MEDICAID | ZX3703 |
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