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Individual

DR. EVAN J SHORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
760 BELOIT RD, BELVIDERE, IL 61008-1745
(815) 547-5151
(815) 547-5336
Mailing address
3996 RED CEDAR DR UNIT A3, HIGHLANDS RANCH, CO 80126-8066
(303) 470-9696
(216) 584-1364

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019034032
IL
122300000X
Dentist
DEN.00202905
CO
1223G0001X
General Practice Dentistry
7023
AZ
1223G0001X
General Practice Dentistry
DEN.00202905
CO

Other

Enumeration date
12/28/2006
Last updated
01/10/2024
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