Individual
DR. BRYCE ALAN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1000 W NIFONG BLVD STE 130, COLUMBIA, MO 65203-5615
(573) 874-1990
Mailing address
1000 W NIFONG BLVD STE 130, COLUMBIA, MO 65203-5615
(573) 874-1990
(573) 874-1923
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2016021053
MO
1223P0221X
Pediatric Dentistry
Primary
2016021053
MO
1223P0221X
Pediatric Dentistry
DDS-09871
IA
390200000X
Student in an Organized Health Care Education/Training Program
30487
IA
Other
Enumeration date
07/15/2016
Last updated
04/01/2021
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