| Evergreen Dental Associates Llc | |
|
281 Western Ave Augusta ME 04330-4933 | |
| (207) 622-0861 | |
| Not Available |
| Full Name | Evergreen Dental Associates Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 281 Western Ave, Augusta, Maine |
| Authorized Official Name and Position | Mikki M Studley (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 2076220861 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental Associates Llc 281 Western Ave Augusta ME 04330-4933 Ph: (207) 622-0861 | Evergreen Dental Associates Llc 281 Western Ave Augusta ME 04330-4933 Ph: (207) 622-0861 |
| NPI Number | 1013121342 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 03/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013121342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2482 (Maine) | Secondary |
| 1223G0001X | Dentist - General Practice | 3692 (Maine) | Primary |
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