| Evergreen Dental, SC | |
|
2310 E Evergreen Dr Suite A Appleton WI 54913-7404 | |
| (920) 734-0601 | |
| (920) 734-9159 |
| Full Name | Evergreen Dental, SC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2310 E Evergreen Dr, Appleton, Wisconsin |
| Authorized Official Name and Position | Paul Francis Popelka (OWNER) |
| Authorized Official Contact | 9207340601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental, SC 2310 E Evergreen Dr Suite A Appleton WI 54913-7404 Ph: (920) 734-0601 | Evergreen Dental, SC 2310 E Evergreen Dr Suite A Appleton WI 54913-7404 Ph: (920) 734-0601 |
| NPI Number | 1851433114 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851433114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3400W (Wisconsin) | Primary |
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