Organization
SALLY A. EVANS DMD PC
Active
Other names
Lake Lanier Costmetic Institute
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY EVANS DMD (OWNER)
(407) 340-4304
Entity
Organization
Contact information
Practice address
819 THOMPSON BRIDGE RD, GAINESVILLE, GA 30501-1774
(770) 535-8900
(770) 535-8108
Mailing address
819 THOMPSON BRIDGE RD, GAINESVILLE, GA 30501-1774
(770) 535-8900
(770) 535-8108
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DNO13552
GA
Other
Enumeration date
08/31/2014
Last updated
08/31/2014
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