| Evergreen Dental Englewood Llc | |
|
625 W National Rd Ste B Englewood OH 45322-1162 | |
| (937) 836-7911 | |
| Not Available |
| Full Name | Evergreen Dental Englewood Llc |
|---|---|
| Speciality | Dentist |
| Location | 625 W National Rd Ste B, Englewood, Ohio |
| Authorized Official Name and Position | Sabrina Chiu (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7405802000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental Englewood Llc Po Box 17419 Sugar Land TX 77496-7419 Ph: () - | Evergreen Dental Englewood Llc 625 W National Rd Ste B Englewood OH 45322-1162 Ph: (937) 836-7911 |
| NPI Number | 1700683711 |
|---|---|
| Provider Enumeration Date | 02/26/2025 |
| Last Update Date | 02/26/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700683711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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