Green, Gary Wayne

Green, Gary Wayne is an individual health care provider with primary practice located at 16133 Ventura Blvd Suite 1040, Encino CA 91436-2403. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Green, Gary Wayne can be contacted via phone (818) 995-0294.

Contact Information

Primary practice address
16133 Ventura Blvd Suite 1040 Encino CA 91436-2403
Phone: (818) 995-0294
Fax: (818) 995-7549
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 22605 California

Profile Details

NPI number 1992748529
LBN Legal business name Green, Gary Wayne
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Sep 5th, 2011 - about 13 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992748529 NPPES
California Other 954297884 CORP ID #

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