Organization
JASON W. EVISON, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON W EVISON DDS (DIRECTOR)
(907) 225-8228
Entity
Organization
Contact information
Practice address
1621 TONGASS AVE, SUITE 103, KETCHIKAN, AK 99901-6013
(907) 225-8228
Mailing address
1621 TONGASS AVE, SUITE 103, KETCHIKAN, AK 99901-6013
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1235
AK
1223P0221X
Pediatric Dentistry
—
—
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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