Organization
EVERGREEN FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLEN A MONSON DDS (OWNER)
(360) 805-0211
Entity
Organization
Contact information
Practice address
17798 147TH ST SE, MONROE, WA 98272
(360) 805-0211
(360) 863-9222
Mailing address
17798 147TH ST SE, MONROE, WA 98272
(360) 805-0211
(360) 863-9222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7077
WA
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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