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General NPI Number Information
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NPI Number | 1942959416
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Entity Type | Organization
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Legal Business Name | YVETTE CARRILLO DDS MS INC
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 3023 BUNKER HILL ST STE 105
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City | SAN DIEGO
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State | CA
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Zip | 92109-5706
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Country | US
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Telephone | 858-869-9234
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Fax | 619-374-2849
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Provider Business Mailing Address
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Address Line | 5797 MISSION CENTER RD # 202
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City | SAN DIEGO
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State | CA
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Zip | 92108-4300
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Country | US
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Telephone | 909-961-7700
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Fax |
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Authorized Official
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Title or Position | DR. / OWNER
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Name | YVETTE CARRILLO
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Credential | DDS MS
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Telephone | 858-869-9234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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