Individual
EVAN SHIPP
Active
Individual
EVAN SHIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
61852
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
35986
TX
Other
Enumeration date
05/24/2012
Last updated
07/22/2020
Update your record
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