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Organization
THE EVOLVE GROUP HOLDINGS, LLC
Active
Organization
THE EVOLVE GROUP HOLDINGS, LLC
Active
Other names
Evolve Dental, Evolve Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE KINGSTON (CO-FOUNDER)
(309) 532-2059
Entity
Organization
Contact information
Practice address
20136 MACK AVE, GROSSE POINTE WOODS, MI 48236-1820
(309) 532-2059
Mailing address
15766 GLASTONBURY AVE, DETROIT, MI 48223-1318
(309) 532-2059
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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