| Evergreen Dental Llc | |
|
790 Boston Rd Unit 205 Billerica MA 01821-5938 | |
| (404) 932-8875 | |
| Not Available |
| Full Name | Evergreen Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 790 Boston Rd Unit 205, Billerica, Massachusetts |
| Authorized Official Name and Position | Jangwon Huh (PRESIDENT) |
| Authorized Official Contact | 4049328875 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental Llc 790 Boston Rd Unit 205 Billerica MA 01821-5938 Ph: () - | Evergreen Dental Llc 790 Boston Rd Unit 205 Billerica MA 01821-5938 Ph: (404) 932-8875 |
| NPI Number | 1831513126 |
|---|---|
| Provider Enumeration Date | 02/07/2014 |
| Last Update Date | 02/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831513126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN1855668 (Massachusetts) | Primary |
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