Individual
DR. EVIE ALICE GREEN-DILEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1208 W ELM ST, ORANGE, TX 77630-5535
(409) 883-3131
(409) 883-6811
Mailing address
1208 W ELM ST, ORANGE, TX 77630-5535
(409) 883-3131
(409) 883-6811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16906
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001054
BCBS
TX
01
—
706854
UNITED CONCORDIA
TX
Enumeration date
10/19/2006
Last updated
07/08/2007
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