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1811586761
EVERGREEN ORAL SURGERY
TACOMA, WA
NPI
1811586761
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Entity Type
Organization
Authorized Contact
ANGIE MINKS
Credentialing Specialist
740-243-6241
Organization Subpart ?
No
Primary Taxonomy
204E00000X Oral & Maxillofacial Surgery
Enumeration Date
2021-01-14
Last Update Date
2021-01-14
Business Address
EVERGREEN ORAL SURGERY
6050 TACOMA MALL BLVD STE 330
TACOMA, WA 98409-6811
Phone number: 253-473-0651
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Mailing Address
EVERGREEN ORAL SURGERY
13894 SUNLADEN CT
PICKERINGTON, OH 43147-8216
Phone number: 740-243-6241
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