Doctor Name: | DR. JARED DEAN EVANS |
NPI Number: | 1306927892 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.M.D. |
License Number: | DN16714 |
Business Practice Address: | 1327 N Stanford Ln Suite B Liberty Lake, WA - 990195034 |
Business Phone Number: | 5098917070 |
Business Fax Number: | 5098914741 |
Mailing Address: | 1327 N Stanford Ln, Suite B LIBERTY LAKE |
State: | WA |
Postal Code: | 990195034 |
Phone Number: | 5098917070 |
Fax Number: | 5098914741 |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 07/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | DN16714 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |