Individual
MICHAEL EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1326 VILLAGGIO BLVD, BOSSIER CITY, LA 71111-7449
(702) 205-2623
Mailing address
1326 VILLAGGIO BLVD, BOSSIER CITY, LA 71111-7449
(702) 205-2623
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
126900000X
Dental Laboratory Technician
—
—
Other
Enumeration date
02/23/2026
Last updated
02/23/2026
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