Organization
EVERGREEN DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAKIB HALABU D.D.S. (OWNER)
(248) 855-1855
Entity
Organization
Contact information
Practice address
24450 EVERGREEN RD, SUITE 101, SOUTHFIELD, MI 48075-5518
(248) 855-1855
Mailing address
24450 EVERGREEN RD, SUITE 101, SOUTHFIELD, MI 48075-5518
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/26/2013
Last updated
07/26/2013
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