Organization
EVERGREEN DENTAL CENTER
Active
Parent organization
EVERGREEN DENTAL CENTER
Other names
Fort Deposit Dental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN DENTAL CENTER
Authorized official
DR. ROBERT P LOUIS DDS MPH (EXECUTIVE DIRECTOR)
(251) 578-3331
Entity
Organization
Contact information
Practice address
119 OLD FORT ROAD, SUITE B, FORT DEPOSIT, AL 36032
(334) 227-4000
(334) 227-3770
Mailing address
PO BOX 266, 100 EDWINA STREET, EVERGREEN, AL 36401-0266
(251) 578-3331
(251) 578-5277
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD5370-C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009910742
—
AL
05
—
009995725
—
AL
Enumeration date
10/05/2007
Last updated
06/17/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us