Evergreen Family Dentistry
Dentist, General Practice in Yreka, CA. Organization (NPI-2).
NPI number1881806339
StatusActive
Last updated in NPPESJul 19, 2007
Details
- NPI
- 1881806339
- Entity type
- Organization (NPI-2)
- Legal business name
- Evergreen Family Dentistry
- Organization subpart
- No
- Enumeration date
- May 5, 2007
- Last updated
- Jul 19, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 38440 | CA | Yes |
Other names
- Randy D. Krant, DDS (Other Name)
Practice location
310 Evergreen LnYreka, CA 96097-3203
Phone 530-842-2558 · Fax 530-842-9011
Mailing address
310 Evergreen LnYreka, CA 96097-3203
Phone 530-842-2558 · Fax 530-842-9011
Authorized official
Randy Dee Krant
Partner
5308422558
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