Individual
DR. LARRY BRIAN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
55 TOWLER RD, LAWRENCEVILLE, GA 30046-4717
(770) 962-9560
Mailing address
635 E GULF DR UNIT B102, SANIBEL, FL 33957-7121
(239) 472-6982
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN009789
GA
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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