| Dale L Evans LLC | |
|
2104 Newton Dr Ne Covington GA 30014-2456 | |
| (770) 787-0690 | |
| (770) 787-0691 |
| Full Name | Dale L Evans LLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2104 Newton Dr Ne, Covington, Georgia |
| Authorized Official Name and Position | Dale L Evans (OWNER) |
| Authorized Official Contact | 7707870690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dale L Evans LLC 2104 Newton Dr Ne Covington GA 30014-2456 Ph: (770) 787-0690 | Dale L Evans LLC 2104 Newton Dr Ne Covington GA 30014-2456 Ph: (770) 787-0690 |
| NPI Number | 1114384914 |
|---|---|
| Provider Enumeration Date | 01/25/2016 |
| Last Update Date | 01/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114384914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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