Provider Demographics
NPI:1073594271
Name:GREEN, WILLIAM SPALDING IV (DMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SPALDING
Last Name:GREEN
Suffix:IV
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:W.
Other - Middle Name:SPALDING
Other - Last Name:GREEN
Other - Suffix:IV
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2000 RICHARD JONES RD
Mailing Address - Street 2:STE. 166
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2885
Mailing Address - Country:US
Mailing Address - Phone:615-383-8213
Mailing Address - Fax:
Practice Address - Street 1:2000 RICHARD JONES RD
Practice Address - Street 2:STE. 166
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2885
Practice Address - Country:US
Practice Address - Phone:615-383-8213
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0075231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice