Organization
EVERGREEN DENTAL ENGLEWOOD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SABRINA CHIU (CREDENTIALING COORDINATOR)
(740) 580-2000
Entity
Organization
Contact information
Practice address
625 W NATIONAL RD STE B, ENGLEWOOD, OH 45322-1162
(937) 836-7911
Mailing address
PO BOX 17419, SUGAR LAND, TX 77496-7419
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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