# CONVENIENT DENTAL SPECIALISTS BENNETT PLLC

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

## Provider details

- **NPI number:** 1932727732
- **Authorized official:** DR. JOHN PATRICK EVANSON DDS (OWNER)
- **Authorized official phone:** (801) 580-6877

## Contact information

- **Practice address:** 280 E COLFAX AVE, BENNETT, CO 80102-5003
- **Mailing address:** PO BOX 514, BENNETT, CO 80102-0514
- **Mailing address phone:** (801) 580-6877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 07/08/2020
- **Last updated:** 07/08/2020