Individual
DR. AUSTIN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
340 BOATNER ROAD, EGLIN AFB, FL 32542
(850) 883-8050
Mailing address
1501 SAN PEDRO DR SE BLDG 48, 377TH DENTAL SQUADRON, ALBUQUERQUE, NM 87108-5153
(505) 846-3065
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9179
KY
Other
Enumeration date
08/14/2012
Last updated
08/21/2013
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