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Individual

DR. EDWARD E EVANS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
830 W ABRIENDO AVE STE B, PUEBLO, CO 81004-1562
(719) 543-1132
Mailing address
830 W ABRIENDO AVE STE B, PUEBLO, CO 81004-1562
(719) 543-1132
(719) 224-3027

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
204314
CO
122300000X
Dentist
Primary
9501074-9921
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000185777
CO
Enumeration date
08/18/2015
Last updated
02/04/2026
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