Organization
FOREST L. EVANS, D.D.S., P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORA B. EVANS (P.A. SECRETARY)
(803) 484-6041
Entity
Organization
Contact information
Practice address
101 HARRIS ST., BOX 531, BISHOPVILLE, SC 29010-0531
(803) 484-6041
(803) 484-6514
Mailing address
PO BOX 531, 101 HARRIS ST., 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
—
ZA 9699
—
SC
Enumeration date
02/14/2007
Last updated
07/17/2007
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