Evergreen Dental Englewood LLC

NPI #1700683711 in Englewood, Ohio

Provider Information

NPI Number: 1700683711
Entity Type: Organization
Organization Name: Evergreen Dental Englewood LLC
Primary Specialty: Dentist
Enumeration Date: Feb 26, 2025
Last Updated: Feb 26, 2025

Practice Location

Address: 625 W NATIONAL RD STE B
City: Englewood
State: Ohio
ZIP Code: 45322-1162
Phone: (937) 836-7911

Authorized Official

Name: SABRINA CHIU
Title: CREDENTIALING COORDINATOR
Phone: (740) 580-2000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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