| NPI | 1821684713 |
|---|---|
| Doing Business As | EVERGREEN DENTAL ANESTHESIA |
| Entity Type | Organization |
| Authorized Contact | NATHAN JAMES CARILLO President/Owner 562-673-8732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2020-12-15 |