| Evergreen Dental P a | |
|
225 E State Highway 121 Ste 117 Coppell TX 75019-2008 | |
| (972) 315-0811 | |
| (972) 315-0891 |
| Full Name | Evergreen Dental P a |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 225 E State Highway 121 Ste 117, Coppell, Texas |
| Authorized Official Name and Position | Heeje Lee (OWNER) |
| Authorized Official Contact | 9723150811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental P a 225 E State Highway 121 Ste 117 Coppell TX 75019-2008 Ph: (972) 315-0811 | Evergreen Dental P a 225 E State Highway 121 Ste 117 Coppell TX 75019-2008 Ph: (972) 315-0811 |
| NPI Number | 1871876680 |
|---|---|
| Provider Enumeration Date | 09/28/2011 |
| Last Update Date | 09/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871876680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 25602 (Texas) | Primary |
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