Green, Amanda S.

Green, Amanda S. is an sole proprietor health care provider with primary practice located at 763 E. Main Street , Spartanburg SC 29302. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / General Practice is her primary health care specialty. Green, Amanda S. can be contacted via phone (864) 585-8558.

Contact Information

Primary practice address
763 E. Main Street Spartanburg SC 29302
Phone: (864) 585-8558
Fax: (864) 580-4242
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X SC 3703 South Carolina
Dental Providers / Pediatric Dentistry 1223P0221X 738PD South Carolina
Dental Providers / General Practice 1223G0001X 3703 South Carolina

Profile Details

NPI number 1588783344
LBN Legal business name Green, Amanda S.
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 29th, 2007
Last updated Jan 31st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588783344 NPPES
South Carolina MEDICAID ZA9313
South Carolina MEDICAID ZA9481
South Carolina MEDICAID ZX3703

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