| NPI | 1063552818 |
|---|---|
| Doing Business As | EVERGREEN DENTAL MANAGEMENT |
| Entity Type | Organization |
| Authorized Contact | EDWARD E. NOLAN Manager 718-453-8646 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 029668) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2008-08-04 |