NPI | 1659399517 |
---|---|
Doing Business As | EVERGREEN DENTAL |
Entity Type | Organization |
Authorized Contact | CASEY DEAN FINES Owner/Dentist 701-237-6307 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 1949) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2022-07-21 |