Organization
EVANS ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE A EVANS MD DDS MS (OWNER ORTHODONTIST)
(605) 342-7777
Entity
Organization
Contact information
Practice address
600 DAKOTA DRIVE, RAPID CITY, SD 57702-0920
(605) 342-7777
(605) 342-2275
Mailing address
600 DAKOTA DRIVE, RAPID CITY, SD 57702-0920
(605) 342-7777
(605) 342-2275
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
M267
SD
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
M719
SD
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
M914
SD
Other
Enumeration date
10/25/2006
Last updated
08/22/2020
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