# DR. G. RANDALL EVANS, D.D.S., F.A.G.D.

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

## Provider details

- **NPI number:** 1013294792
- **Authorized official:** DR. GARY RANDALL EVANS D.D.S. (OWNER)
- **Authorized official phone:** (903) 454-0918

## Contact information

- **Practice address:** 4319 RIDGECREST RD, GREENVILLE, TX 75402-6004
- **Practice address phone:** (903) 454-0918
- **Practice address fax:** (903) 454-7540
- **Mailing address:** 4319 RIDGECREST RD, GREENVILLE, TX 75402-6004
- **Mailing address phone:** (903) 454-0918
- **Mailing address fax:** (903) 454-7540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 11800 | TX | Yes |
| 1223G0001X | General Practice Dentistry | 21548 | TX | — |

## Other

- **Enumeration date:** 11/09/2011
- **Last updated:** 11/09/2011