| Evergreen Dental, Inc. | |
|
833 N Wilke Rd Arlington Heights IL 60005-1047 | |
| (847) 999-8004 | |
| Not Available |
| Full Name | Evergreen Dental, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 833 N Wilke Rd, Arlington Heights, Illinois |
| Authorized Official Name and Position | Timothy P Bashford (OWNER/DENTIST) |
| Authorized Official Contact | 8479998004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental, Inc. Po Box 8347 Northfield IL 60093-8347 Ph: (847) 999-8004 | Evergreen Dental, Inc. 833 N Wilke Rd Arlington Heights IL 60005-1047 Ph: (847) 999-8004 |
| NPI Number | 1396343133 |
|---|---|
| Provider Enumeration Date | 10/14/2020 |
| Last Update Date | 09/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396343133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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