Individual
DR. EVAN DEUTH FIEDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
100 N MCCOY ST, GRANVILLE, IL 61326-9329
(815) 339-6888
(815) 339-6738
Mailing address
100 N MCCOY ST, P.O. BOX 597, GRANVILLE, IL 61326-9329
(815) 339-6888
(815) 339-6738
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027937
IL
Other
Enumeration date
06/30/2009
Last updated
03/25/2010
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