# EVERGREEN DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235177734
- **Authorized official:** DR. T. KEVIN DANG DDS (PRESIDENT)
- **Authorized official phone:** (425) 385-3170

## Contact information

- **Practice address:** 10315 19TH AVE SE, STE 102, EVERETT, WA 98208-4259
- **Practice address phone:** (425) 385-3170
- **Practice address fax:** (425) 385-3907
- **Mailing address:** 10315 19TH AVE SE, STE 102, EVERETT, WA 98208-4259
- **Mailing address phone:** (425) 385-3170
- **Mailing address fax:** (425) 385-3907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2006
- **Last updated:** 08/22/2020