# GREGORY A EVANOFF DDS PC

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

## Provider details

- **NPI number:** 1619088770
- **Authorized official:** GREGORY A EVANOFF DDS (OWNER DENTIST)
- **Authorized official phone:** (701) 852-3222

## Contact information

- **Practice address:** 1000 31ST AV SW, MINOT, ND 58701-6958
- **Practice address phone:** (701) 852-3222
- **Practice address fax:** (701) 852-2767
- **Mailing address:** 1000 31ST AV SW, MINOT, ND 58701-6958
- **Mailing address phone:** (701) 852-3222
- **Mailing address fax:** (701) 852-2767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 1712 | ND | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41289 | — | ND |