Organization
EVERGREEN PROSTHODONTIC ASSOCIATES, LLC
Active
Parent organization
EVERGREEN PROSTHODONTIC ASSOCIATES, LLC
Other names
Southbury Smiles
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN PROSTHODONTIC ASSOCIATES, LLC
Authorized official
DR. MICHELLE NA DDS (OWNER)
(203) 264-1620
Entity
Organization
Contact information
Practice address
2 POMPERAUG OFFICE PARK STE 304, SOUTHBURY, CT 06488-2288
(203) 264-1620
Mailing address
2 POMPERAUG OFFICE PARK STE 304, SOUTHBURY, CT 06488-2288
(203) 264-1620
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
12/01/2013
Last updated
03/30/2023
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