| Evergreen Dental Center | |
|
100 Edwina Street Evergreen AL 36401 | |
| (251) 578-3331 | |
| (251) 578-2006 |
| Full Name | Evergreen Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 100 Edwina Street, Evergreen, Alabama |
| Authorized Official Name and Position | Robert P Louis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2515783331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental Center Po Box 266 Evergreen AL 36401 Ph: (251) 578-3331 | Evergreen Dental Center 100 Edwina Street Evergreen AL 36401 Ph: (251) 578-3331 |
| NPI Number | 1467526038 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467526038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD5370C (Alabama) | Primary |
Tri County Medical Center Inc Dental Clinic Medicare: Medicare Enrolled Practice Location: 316 S Main St, Evergreen, AL 36401 Phone: 251-578-1163 |