# SAN DIEGO MAXILLOFACIAL SURGERY, EVANS-HAMMER DENTAL CORPORATION

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

## Provider details

- **NPI number:** 1093523656
- **Authorized official:** BRIAN EVANS (OWNER/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (858) 335-8892

## Contact information

- **Practice address:** 2185 CITRACADO PKWY, ESCONDIDO, CA 92029-4159
- **Practice address phone:** (805) 455-6057
- **Mailing address:** PO BOX 27028, SAN DIEGO, CA 92198-1028
- **Mailing address phone:** (805) 455-6057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 12/27/2024
- **Last updated:** 12/27/2024