| NPI | 1093695199 |
|---|---|
| Doing Business As | EVERGREEN DENTAL |
| Entity Type | Organization |
| Authorized Contact | HANNAH ELIZABETH GROH CEO 317-213-7439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-09-08 |
| Last Update Date | 2025-09-08 |