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Individual
DR. SUSAN EVANS
Active
Individual
DR. SUSAN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S, P.A.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6173
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326149196
ORGANIZATION NPI
KS
01
—
6173
STATE LICENSE NUMBER
KS
Enumeration date
09/16/2014
Last updated
04/14/2020
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