Individual
JESSICA BETH EVANGELIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, OMT
Contact information
Practice address
3601 VANESTA DR, MANHATTAN, KS 66503-0387
(816) 225-8734
Mailing address
3601 VANESTA DR, MANHATTAN, KS 66503-0387
(816) 225-8734
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
10714
KS
174400000X
Specialist
Primary
10714
KS
Other
Enumeration date
03/29/2022
Last updated
04/08/2022
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