| NPI | 1134520943 |
|---|---|
| Doing Business As | EVERGREEN FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | LUAN TRAN LE Dentist/President 408-270-1120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 39029) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-09-11 |