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Evergreen Dental Group, Llc
Pediatric Dentist in South Windsor, Connecticut
NPI 1457641136

Evergreen Dental Group, Llc is a Pediatric Dentist based in South Windsor, CT and is specialized in Pediatric Dentistry. Evergreen Dental Group, Llc practices in South Windsor, CT. The NPI Number for Evergreen Dental Group, Llc is 1457641136 and holds a License No. 010110 (Connecticut).

The current practice location address for Evergreen Dental Group, Llc is 34 Evergreen Way, South Windsor, CT and can be reached out via phone at 917-453-4055.

Location: 34 Evergreen Way, South Windsor, CT, 06074-6976
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1457641136
Provider Name
Evergreen Dental Group, Llc
Credential
Provider Entity Type
Organization
Address
34 Evergreen Way, South Windsor, CT, 06074-6976
Phone Number
917-453-4055
Fax Number
Provider Enumeration Date
04/14/2011
Last Update Date
03/12/2024
institution
Provider Business Practice Location Address Details
Address
34 Evergreen Way
City
South Windsor
State
Connecticut
Zip
06074-6976
Phone Number
917-453-4055
Fax Number
person
Provider Business Mailing Address Details
Address
34 Evergreen Way
City
South Windsor
State
Connecticut
Zip
06074-6976
Phone Number
917-453-4055
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
010241 (Connecticut)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
010110 (Connecticut)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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