| Evergreen Dental Llc | |
|
109 Boston Post Rd Orange CT 06477-3235 | |
| (203) 298-0446 | |
| Not Available |
| Full Name | Evergreen Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 109 Boston Post Rd, Orange, Connecticut |
| Authorized Official Name and Position | Vikas Goel (OWNER) |
| Authorized Official Contact | 2032980446 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental Llc 5213 Avalon Dr W Orange CT 06477-3677 Ph: (203) 298-0466 | Evergreen Dental Llc 109 Boston Post Rd Orange CT 06477-3235 Ph: (203) 298-0446 |
| NPI Number | 1730464470 |
|---|---|
| Provider Enumeration Date | 10/13/2011 |
| Last Update Date | 10/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730464470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 010332 (Connecticut) | Primary |
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