Individual
DR. EVAN JAMES EVANISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
400 WYOMING AVE STE 300, SCRANTON, PA 18503-1238
(570) 342-8800
Mailing address
304 HILLSIDE DR, MOSCOW, PA 18444-8624
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS043637
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/20/2022
Last updated
06/13/2022
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