Individual
EVAN C. KNEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11187 SHERIDAN BLVD, UNIT 12, WESTMINSTER, CO 80020-3231
(303) 469-2333
(303) 469-2011
Mailing address
11187 SHERIDAN BLVD, UNIT 12, WESTMINSTER, CO 80020-3231
(303) 469-2333
(303) 469-2011
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8027
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57002754
—
CO
Enumeration date
07/06/2006
Last updated
07/08/2007
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