Individual
DR. EVAN C KOUBSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2302 HENDRICKSON DR, EAU CLAIRE, WI 54701-6185
(715) 836-0136
Mailing address
225 RIVERFRONT TER APT 306, EAU CLAIRE, WI 54703-6399
(320) 291-8449
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001532
WI
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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