Evergreen Dental, Sc

NPI #1851433114 in Appleton, Wisconsin

Provider Information

NPI Number: 1851433114
Entity Type: Organization
Organization Name: Evergreen Dental, Sc
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 13, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 2310 E EVERGREEN DR
Address 2: SUITE A
City: Appleton
State: Wisconsin
ZIP Code: 54913-7404
Phone: (920) 734-0601

Authorized Official

Name: DR. PAUL FRANCIS POPELKA, DDS
Title: OWNER
Phone: (920) 734-0601

Specialties & Taxonomy Codes

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

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