Green, Jerry Allan
Green, Jerry Allan is an sole proprietor health care provider with primary practice located at 3932 Wilshire Blvd Suite 100, Los Angeles CA 90010-3307. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Green, Jerry Allan can be contacted via phone (213) 386-3336.Contact Information
Primary practice address
3932 Wilshire Blvd Suite 100
Los Angeles CA 90010-3307
Phone: (213) 386-3336
Fax: (213) 386-2935
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | 17833 | California |
Profile Details
| NPI number | 1437295284 |
|---|---|
| LBN Legal business name | Green, Jerry Allan |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437295284 | NPPES |
| California | Other | 17833 | DENTAL LICENCE |
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