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Organization
RANDOLPH T. EVANS, D.D.S. P.L.L.C.
Active
Organization
RANDOLPH T. EVANS, D.D.S. P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH TERRY EVANS D.D.S. (OWNER)
(304) 263-3131
Entity
Organization
Contact information
Practice address
22 SIERRA DRIVE, MARTINSBURG, WV 25403-1133
(304) 263-3131
(304) 263-4493
Mailing address
22 SIERRA DRIVE, MARTINSBURG, WV 25403-1133
(304) 263-3131
(304) 263-4493
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2987
WV
1223G0001X
General Practice Dentistry
3708
WV
Other
Enumeration date
04/26/2007
Last updated
08/22/2020
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