Provider Demographics
NPI:1932754686
Name:CHRISTOPHER GREEN DMD PLLC
Entity Type:Organization
Organization Name:CHRISTOPHER GREEN DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:720-845-5252
Mailing Address - Street 1:19551 HESS RD # 100
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3448
Mailing Address - Country:US
Mailing Address - Phone:720-845-5252
Mailing Address - Fax:
Practice Address - Street 1:19551 HESS RD # 100
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3448
Practice Address - Country:US
Practice Address - Phone:720-845-5252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental