| Evergreen Dental Partners Llp | |
|
1232 Bergen Pkwy Evergreen CO 80439-9573 | |
| (303) 674-6070 | |
| Not Available |
| Full Name | Evergreen Dental Partners Llp |
|---|---|
| Speciality | Dentist |
| Location | 1232 Bergen Pkwy, Evergreen, Colorado |
| Authorized Official Name and Position | Gary D Rotolo (PARTNER) |
| Authorized Official Contact | 3036746070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental Partners Llp 1232 Bergen Pkwy Evergreen CO 80439-9573 Ph: (303) 674-6070 | Evergreen Dental Partners Llp 1232 Bergen Pkwy Evergreen CO 80439-9573 Ph: (303) 674-6070 |
| NPI Number | 1356621122 |
|---|---|
| Provider Enumeration Date | 08/24/2011 |
| Last Update Date | 08/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356621122 | NPI | - | NPPES |
| 69708533 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8121 (Colorado) | Primary |
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