Individual
MS. ERICA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDA, CDA, CHW
Contact information
Practice address
1405 ANNE ST NW, BEMIDJI, MN 56601-5113
(218) 444-9646
(218) 444-9252
Mailing address
1405 ANNE ST NW, BEMIDJI, MN 56601-5113
(218) 444-9646
(218) 444-9252
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
A13922
MN
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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