Green, Lisa
Green, Lisa is an sole proprietor health care provider with primary practice located at 10590 Enduring Freedom Dr , Fort Drum NY 13602-5005. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. Green, Lisa can be contacted via phone (315) 772-6234.Contact Information
Primary practice address
10590 Enduring Freedom Dr
Fort Drum NY 13602-5005
Phone: (315) 772-6234
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Assistant | 126800000X |
Profile Details
| NPI number | 1760831457 |
|---|---|
| LBN Legal business name | Green, Lisa |
| Credentials | DENTAL ASSISTANTEFDA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 3rd, 2016 |
| Last updated | Jun 3rd, 2016 - about 9 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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