| Evergreen Dental | |
|
2403 E Evergreen Blvd Vancouver WA 98661-4320 | |
| (360) 696-1671 | |
| Not Available |
| Full Name | Evergreen Dental |
|---|---|
| Speciality | Dentist |
| Location | 2403 E Evergreen Blvd, Vancouver, Washington |
| Authorized Official Name and Position | Chad G Wade (DENTIST) |
| Authorized Official Contact | 3609212396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dental 2403 E Evergreen Blvd Vancouver WA 98661-4320 Ph: (360) 696-1671 | Evergreen Dental 2403 E Evergreen Blvd Vancouver WA 98661-4320 Ph: (360) 696-1671 |
| NPI Number | 1700222197 |
|---|---|
| Provider Enumeration Date | 05/13/2013 |
| Last Update Date | 05/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700222197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE60041682 (Washington) | Primary |
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