Provider Demographics
NPI:1992875785
Name:GREEN, WILLIAM JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:GREEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 WADSWORTH BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-4439
Mailing Address - Country:US
Mailing Address - Phone:303-422-7610
Mailing Address - Fax:303-423-5911
Practice Address - Street 1:6425 WADSWORTH BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-4439
Practice Address - Country:US
Practice Address - Phone:303-422-7610
Practice Address - Fax:303-423-5911
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist