Organization
EVERGREEN DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD RUDEN DMD (OWNER)
(609) 226-6489
Entity
Organization
Contact information
Practice address
549 S EVERGREEN AVE, WOODBURY, NJ 08097-1004
(609) 226-6489
Mailing address
549 S EVERGREEN AVE, WOODBURY, NJ 08097-1004
(609) 226-6489
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI01430100
NJ
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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