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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JACK L GREEN JR., DDS MSD

Active Sole Proprietor

DR. JACK L GREEN JR., DDS MSD is a Orthodontics healthcare provider located in MYRTLE BEACH, South Carolina. NPI 1770608119 is currently active in the NPPES registry. Verify at CMS.

Orthodontics · MYRTLE BEACH, SC

Registration Details

NPI Number
1770608119
Provider Type
Individual
Gender
Male
NPI Issued
Mar 21, 2007 (19.376796007082 yrs)
Last Updated
Jul 8, 2007
License
1629 (SC)
Sole Proprietor
Yes

Practice Information

Address
1201 48TH AVE N
MYRTLE BEACH, SC, 295775432
Browse SC providers · Browse ZIP 29577
Phone
8434491444
Fax
8434492768
Primary Specialty
Orthodontics
1223X0400X

Other Orthodontics Providers in MYRTLE BEACH, SC

Name Credential NPI
DR. RUSSELL B MCCRACKEN DMD 1750581682
JUAN FAJA-FERNANDEZ D.M.D. 1053754127
STEPHANIE BECKER 1639745326
KELLY SCHWEERS DMD, MSD 1518719830
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.