Tamara Green, RDH
Individual provider Active NPI Dental Hygienist · Mauston, WI
NPI 1225544679 · NPPES record last updated Dec 21, 2017
Key facts
- NPI
- 1225544679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 9731 (WI)
- Practice address
- 880 Herriot Dr
Mauston, WI 53948-2031 - Phone
- (608) 847-6700
- Fax
- (608) 847-6122
- NPI assigned
- Dec 21, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9731 | WI | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica de Los Campesinos, Inc | Past | Accepting new patients | |
| La Clinica de Los Campesinos, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 9731 | WI | Yes |
Addresses
Primary practice location
880 Herriot Dr
Mauston, WI 53948-2031
Mailing address
PO Box 1440
Wautoma, WI 54982-1440
Phone (920) 787-5514
Other names
- Tamra Green
Other providers in Mauston, WI
- Joann Geiger
- Mary Ann Gerrard
- Staci M Glynn
- Shaylyn Goldbeck
- James Michael Grannell
- Lisa Ruth Gregar
- Craig William Griffis
- Bobbie Gurgel
- Cody R Gust
- Julia Habelman
All providers in Mauston, WI · Dental Hygienist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.