Individual
JEFFREY EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4501 DALY DR STE 310, CHANTILLY, VA 20151-3707
(703) 378-1010
Mailing address
4501 DALY DR STE 310, CHANTILLY, VA 20151-3707
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416984
VA
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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