Organization
EVERGREEN DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT P LOUIS DDS (EXECUTIVE DIRECTOR)
(251) 578-3331
Entity
Organization
Contact information
Practice address
100 EDWINA STREET, EVERGREEN, AL 36401
(251) 578-3331
(251) 578-2006
Mailing address
PO BOX 266, EVERGREEN, AL 36401
(251) 578-3331
(251) 578-2006
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD5370C
AL
Other
Enumeration date
11/17/2006
Last updated
08/22/2020
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