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Dr. James Russell Green IV, DMD
Oral and Maxillofacial Surgery (Dentist) in Tampa, Florida
NPI 1396970653

James Russell Green IV is a Oral and Maxillofacial Surgery (Dentist) based in Tampa, FL and is specialized in Oral and Maxillofacial Surgery. James Russell Green IV practices in Tampa, FL and has the professional credentials of DMD. The NPI Number for James Russell Green IV is 1396970653 and holds a License No. P64379 (Florida).

The current practice location address for James Russell Green IV is 1309 W Fletcher Ave, Tampa, FL and can be reached out via phone at 813-960-5540.

Location: 1309 W Fletcher Ave, Tampa, FL, 33612
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396970653
Provider Name
James Russell Green IV
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
1309 W Fletcher Ave, Tampa, FL, 33612
Phone Number
813-960-5540
Fax Number
Provider Enumeration Date
05/15/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1309 W Fletcher Ave
City
Tampa
State
Florida
Zip
33612
Phone Number
813-960-5540
Fax Number
person
Provider Business Mailing Address Details
Address
1309 W Fletcher Ave
City
Tampa
State
Florida
Zip
33612
Phone Number
813-960-5540
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
P64379 (New York)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
P64379 (New York)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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