Evergreen Dental Group

NPI #1215104336 in Evergreen, Colorado

Provider Information

NPI Number: 1215104336
Entity Type: Organization
Organization Name: Evergreen Dental Group
Primary Specialty: Dentist - General Practice
Enumeration Date: May 8, 2008
Last Updated: May 8, 2008

Practice Location

Address: 31226 LEWIS RIDGE RD
City: Evergreen
State: Colorado
ZIP Code: 80439-7998
Phone: (303) 674-5566

Authorized Official

Name: DR. DONALD SHARP
Title: DENTIST
Phone: (303) 674-5566

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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