# EVERGREEN FAMILY DENTAL, MILL CREEK, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396601688
- **Authorized official:** CAITLYN BATES (OFFICE MANAGER)
- **Authorized official phone:** (425) 338-4999

## Contact information

- **Practice address:** 15224 MAIN ST STE 301, MILL CREEK, WA 98012-7332
- **Practice address phone:** (425) 338-4999
- **Practice address fax:** (425) 338-1055
- **Mailing address:** 15224 MAIN ST STE 301, MILL CREEK, WA 98012-7332
- **Mailing address phone:** (425) 338-4999
- **Mailing address fax:** (425) 338-1055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/30/2025
- **Last updated:** 12/30/2025