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Organization

EVERGREEN DENTAL P A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HEEJE LEE D.D.S. (OWNER)
(972) 315-0811
Entity
Organization

Contact information

Practice address
225 E STATE HIGHWAY 121 STE 117, COPPELL, TX 75019-2008
(972) 315-0811
(972) 315-0891
Mailing address
225 E STATE HIGHWAY 121 STE 117, COPPELL, TX 75019-2008
(972) 315-0811
(972) 315-0891

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25602
TX

Other

Enumeration date
09/28/2011
Last updated
09/28/2011
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