Green, Michael Brandon

Green, Michael Brandon is an individual health care provider with primary practice located at 9217 Redwood Rd Suite B, West Jordan UT 84088-5826. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Green, Michael Brandon can be contacted via phone (801) 566-1873.

Contact Information

Primary practice address
9217 Redwood Rd Suite B West Jordan UT 84088-5826
Phone: (801) 566-1873
Fax: (801) 307-0215
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6229925 Utah

Profile Details

NPI number 1861606584
LBN Legal business name Green, Michael Brandon
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2007
Last updated Jul 9th, 2007 - about 18 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 1861606584 NPPES
Utah MEDICAID 528373269007

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