Individual
EVAN JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
519 MEMORIAL DR SE UNIT D1, ATLANTA, GA 30312-2290
(404) 709-2903
Mailing address
2870 PEACHTREE RD NW # 1535, ATLANTA, GA 30305-2918
(423) 847-5239
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
105877
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
123212
GA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4397-23
MS
Other
Enumeration date
04/15/2019
Last updated
07/24/2025
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