OrganizationActive
Brad H. Green D.D.S., P.A.
NPI 1205175676 · Dentist · Fayetteville, AR
Provider details
- NPI number
- 1205175676
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Brad Green, Owner(479) 445-7281
- License
- 3578 (AR)
Specialties & taxonomies
Dental Providers
Practice location
2421 N Center St
Suite D
Fayetteville, AR 72701-9455
Phone: (479) 445-6919
Fax: (479) 445-6929
Approximate (ZIP-level) locationGet directions
Mailing address
101 S Pittman St
Prairie Grove, AR 72753-3247
Registry dates
- Enumerated
- 2013-02-05
- Last updated
- 2013-02-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.