Organization
G S EVANS DDS PA
Active
Other names
Straight Teeth Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD SCOTT EVANS DDS (OWNER)
(214) 337-5200
Entity
Organization
Contact information
Practice address
3434 W ILLINOIS AVE, SUITE204, DALLAS, TX 75211-8796
(214) 337-5200
(214) 337-5204
Mailing address
3434 W ILLINOIS AVE, SUITE204, DALLAS, TX 75211-8796
(214) 337-5200
(214) 337-5204
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
15030
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166592903
—
TX
Enumeration date
02/08/2011
Last updated
02/08/2011
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