| Evergreen Family Dentistry | |
|
17798 147th St Se Monroe WA 98272 | |
| (360) 805-0211 | |
| (360) 863-9222 |
| Full Name | Evergreen Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 17798 147th St Se, Monroe, Washington |
| Authorized Official Name and Position | Glen A Monson (OWNER) |
| Authorized Official Contact | 3608050211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Family Dentistry 17798 147th St Se Monroe WA 98272 Ph: (360) 805-0211 | Evergreen Family Dentistry 17798 147th St Se Monroe WA 98272 Ph: (360) 805-0211 |
| NPI Number | 1497879001 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497879001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7077 (Washington) | Primary |
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