| G S Evans Dds Pa | |
|
3434 W Illinois Ave Suite204 Dallas TX 75211-8796 | |
| (214) 337-5200 | |
| (214) 337-5204 |
| Full Name | G S Evans Dds Pa |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3434 W Illinois Ave, Dallas, Texas |
| Authorized Official Name and Position | Gerald Scott Evans (OWNER) |
| Authorized Official Contact | 2143375200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| G S Evans Dds Pa 3434 W Illinois Ave Suite204 Dallas TX 75211-8796 Ph: (214) 337-5200 | G S Evans Dds Pa 3434 W Illinois Ave Suite204 Dallas TX 75211-8796 Ph: (214) 337-5200 |
| NPI Number | 1235435298 |
|---|---|
| Provider Enumeration Date | 02/08/2011 |
| Last Update Date | 02/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235435298 | NPI | - | NPPES |
| 166592903 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 15030 (Texas) | Primary |
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