Individual
DR. FOREST LUKE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
101 HARRIS STREET,, BISHOPVILLE, SC 29010-0531
(803) 484-6041
(803) 484-6514
Mailing address
PO BOX 531, BISHOPVILLE, SC 29010-0531
(803) 484-6041
(803) 484-6514
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1623
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z1623-3
—
SC
Enumeration date
10/31/2006
Last updated
08/01/2007
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