Individual
AUBRIE J EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2301 S HIGHWAY 65 STE 1, MARSHALL, MO 65340-3713
(660) 886-9500
Mailing address
2301 S HIGHWAY 65 STE 1, MARSHALL, MO 65340-3713
(660) 202-9593
(660) 675-3002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2018019129
MO
1223G0001X
General Practice Dentistry
Primary
2018019129
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235622218
INDIVIDUAL
MO
Enumeration date
06/13/2018
Last updated
06/09/2021
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