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Dr. Gordon Keith Green, DDS
General Practice Dentistry in Lyons, Indiana
NPI 1265450464

Gordon Keith Green is a General Practice Dentistry based in Lyons, IN and is specialized in General Practice. Gordon Keith Green practices in Lyons, IN and has the professional credentials of DDS. The NPI Number for Gordon Keith Green is 1265450464 and holds a License No. 7342 (Indiana).

The current practice location address for Gordon Keith Green is 147 E Broad St, Lyons, IN and can be reached out via phone at 812-659-2111 and via fax at 812-659-2808. You can also correspond with Gordon Keith Green through the mailing address at P O BOX 501, LYONS, IN - 47443-9502 (mailing address contact number: 812-659-2111).

Location: 147 E Broad St, Lyons, IN, 47443-9502
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265450464
Provider Name
Gordon Keith Green
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
147 E Broad St, Lyons, IN, 47443-9502
Phone Number
812-659-2111
Fax Number
812-659-2808
Provider Enumeration Date
07/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100124690A 05 IN
457474 01 IN UNITED CONCORDIA
institution
Provider Business Practice Location Address Details
Address
147 E Broad St
City
Lyons
State
Indiana
Zip
47443-9502
Phone Number
812-659-2111
Fax Number
812-659-2808
person
Provider Business Mailing Address Details
Address
P O Box 501
City
Lyons
State
Indiana
Zip
47443-9502
Phone Number
812-659-2111
Fax Number
812-659-2808
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
7342 (Indiana)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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