| Evergreen Dental Pa | |
|
549 S Evergreen Ave Woodbury NJ 08097-1004 | |
| (609) 226-6489 | |
| Not Available |
| Full Name | Evergreen Dental Pa |
|---|---|
| Speciality | Dentist |
| Location | 549 S Evergreen Ave, Woodbury, New Jersey |
| Authorized Official Name and Position | Richard Ruden (OWNER) |
| Authorized Official Contact | 6092266489 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental Pa 549 S Evergreen Ave Woodbury NJ 08097-1004 Ph: (609) 226-6489 | Evergreen Dental Pa 549 S Evergreen Ave Woodbury NJ 08097-1004 Ph: (609) 226-6489 |
| NPI Number | 1649703216 |
|---|---|
| Provider Enumeration Date | 04/10/2017 |
| Last Update Date | 04/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649703216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22DI01430100 (New Jersey) | Primary |
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