Individual
DR. EVAN L PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D D S
Contact information
Practice address
320 RIVER PARK DR, SUITE 225, PROVO, UT 84604-6060
(801) 225-7111
(801) 764-9777
Mailing address
320 RIVER PARK DR, SUITE 225, PROVO, UT 84604-6060
(801) 225-7111
(801) 764-9777
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
142103
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134244734
GROUP NPI
UT
Enumeration date
05/01/2012
Last updated
05/01/2012
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