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Organization

DR. G. RANDALL EVANS, D.D.S., F.A.G.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY RANDALL EVANS D.D.S. (OWNER)
(903) 454-0918
Entity
Organization

Contact information

Practice address
4319 RIDGECREST RD, GREENVILLE, TX 75402-6004
(903) 454-0918
(903) 454-7540
Mailing address
4319 RIDGECREST RD, GREENVILLE, TX 75402-6004
(903) 454-0918
(903) 454-7540

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11800
TX
1223G0001X
General Practice Dentistry
21548
TX

Other

Enumeration date
11/09/2011
Last updated
11/09/2011
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