Evergreen Dental Group, Llc

LBN: Evergreen Dental Group, Llc
Evergreen Dental Group, Llc is an health care organization with primary practice located at 34 Evergreen Way , South Windsor CT 06074-6976. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / General Practice is the primary health care specialty. Evergreen Dental Group, Llc can be contacted via phone (917) 453-4055, or through Kwon, Chia Hui Jenny via phone (917) 453-4055.

Contact Information

Primary practice address
34 Evergreen Way South Windsor CT 06074-6976
Phone: (917) 453-4055
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kwon, Chia Hui Jenny
Phone: (917) 453-4055

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 010110 Connecticut
Dental Providers / General Practice 1223G0001X 010241 Connecticut
Dental Providers / Pediatric Dentistry 1223P0221X 010004 Connecticut

Profile Details

NPI number 1457641136
LBN Legal business name Evergreen Dental Group, Llc
DBA Doing business as
Authorized official Kwon, Chia Hui Jenny
Entity Organization
Organization subpart 1 No
Enumeration date Apr 14th, 2011
Last updated Apr 14th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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