Evergreen Plaza Dental, Inc in Mendocino - Dental
Evergreen Plaza Dental, Inc - NPI 1750406963
Evergreen Plaza Dental, Inc is a Dental in Mendocino, California. Evergreen Plaza Dental, Inc practices all healthcare services and medical treatments related to Dental. The NPI Number for Evergreen Plaza Dental, Inc is 1750406963. The last update date is 2009-09-12.
Evergreen Plaza Dental, Inc's current location address is Po Box 2477, Mendocino, California. You can contact this provider via phone number 7079644759. The mailing address for Evergreen Plaza Dental, Inc is Po Box 2477, Mendocino, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Evergreen Plaza Dental, Inc |
|---|---|
| Address | Po Box 2477, Mendocino, California |
| Phone Number | 7079644759 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Carney Patrick |
| Credentials | DDS |
| Telephone Number | 7079644759 |
NPI Number Detail
| NPI Number | 1750406963 |
|---|---|
| Provider Enumeration Date | 2007-03-20 |
| Last Updated Date | 2009-09-12 |
Provider Mailing Address Detail
| Address | Po Box 2477 |
|---|---|
| City | Mendocino |
| State | California (CA) |
| Post Code | 954602477 |
| Phone Number | 7079644759 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
| Licence No | 27738 |
|
Definition: Provides general and specialized dental care and oral surgery. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 27738 | CA | DENTAL LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Evergreen Plaza Dental, Inc by the Centers for Medicare & Medicaid Services?
The Evergreen Plaza Dental, Inc has been assigned the NPI (National Provider Identifier) 1750406963 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Evergreen Plaza Dental, Inc's facilities are geographically located?
The facilities of Evergreen Plaza Dental, Inc are physically situated at the following location: Po Box 2477, Mendocino, CA, 954602477.
What is Evergreen Plaza Dental, Inc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Evergreen Plaza Dental, Inc is Dental, and the taxonomy code that classifies this field of practice is 261Qd0000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1750406963 to Evergreen Plaza Dental, Inc?
The Centers for Medicare & Medicaid Services assigned the 1750406963 to Evergreen Plaza Dental, Inc on 2007-03-20.
When was the information related to Evergreen Plaza Dental, Inc most recently updated or refreshed?
The details pertaining to the Evergreen Plaza Dental, Inc, including its address, specialty, and other relevant information, were last updated or refreshed on 2009-09-12.
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