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Individual

MRS. SALLY EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
819 THOMPSON BRIDGE RD, GAINESVILLE, GA 30501-1774
(770) 535-8900
Mailing address
819 THOMPSON BRIDGE RD, GAINESVILLE, GA 30501-1774
(770) 535-8900

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013552
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
593260957
TAX ID
GA
Enumeration date
06/01/2007
Last updated
07/08/2007
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