Evergreen Dental Associates Llc

NPI 1013121342 - Dentist - 1223G0001X

NPI Details
NPI 1013121342
Enumeration Date 05/09/2007
Last Updated 03/13/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MIKKI M MIKKI
Position PRACTICE ADMINISTRATOR
Phone (207) 622-0861
Fax
Practice Location
281 WESTERN AVE
AUGUSTA ME, 04330-4933, US
Phone (207) 622-0861
Fax
Business Location
281 WESTERN AVE
AUGUSTA ME, 04330-4933, US
Phone (207) 622-0861
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Maine
License Number 2482
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According to our database, Evergreen Dental Associates Llc NPI is 1013121342, taxonomy code is 1223G0001X and license number is 2482, license state is located at Maine. Evergreen Dental Associates Llc physically located at 281 Western Ave, Augusta ME, 04330-4933. NPI Number 1033115704 has the healthcare provider type.

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1013121342 NPI number is provided on an as is basis without warranty of any kind. 1013121342 is maintained by the National Plan & Provider Enumeration System. The contents of Evergreen Dental Associates Llc are for informational purposes only.