Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jack L Green Jr., DDSMSD

Individual provider Orthodontics and Dentofacial Orthopedics Dentistry · NPI 1770608119

Dr. Jack L Green Jr., DDSMSD is an Orthodontics and Dentofacial Orthopedics Dentistry in Myrtle Beach, South Carolina. Practices as a sole proprietor. Licensed in South Carolina.

Licensed in
SC
In the registry since
2007

Practice location Address checks out

1201 48th Ave N
Myrtle Beach, SC 29577-5432
Phone: (843) 449-1444
Fax: (843) 449-2768
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X · Licence 1629 (SC)

Record details

NPI number1770608119
Entity typeIndividual (Type 1)
GenderMale
Credentials DDSMSD
Sole proprietorYes
NPI enumeratedMarch 21, 2007
Last updated in NPPESJuly 8, 2007

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