Organization
EVERGREEN DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY P BASHFORD DDS (OWNER/DENTIST)
(847) 999-8004
Entity
Organization
Contact information
Practice address
833 N WILKE RD, ARLINGTON HEIGHTS, IL 60005-1047
(847) 999-8004
Mailing address
PO BOX 8347, NORTHFIELD, IL 60093-8347
(847) 999-8004
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/14/2020
Last updated
09/20/2023
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