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Organization
CONVENIENT DENTAL SPECIALISTS BENNETT PLLC
Active
Organization
CONVENIENT DENTAL SPECIALISTS BENNETT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PATRICK EVANSON DDS (OWNER)
(801) 580-6877
Entity
Organization
Contact information
Practice address
280 E COLFAX AVE, BENNETT, CO 80102-5003
Mailing address
PO BOX 514, BENNETT, CO 80102-0514
(801) 580-6877
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
NULL
1223E0200X
Endodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
NULL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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