| NPI | 1972099620 |
|---|---|
| Doing Business As | EVERGREEN DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | JASON WILLIAM HARTMAN Owner 517-484-5811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-05 |