Organization
BEAU EVANS FAMILY DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEAU BARKER EVANS DDS (DENTIST/OWNER)
(918) 652-4404
Entity
Organization
Contact information
Practice address
202 S 6TH ST, HENRYETTA, OK 74437-5002
(918) 652-4404
(918) 652-4445
Mailing address
202 S 6TH ST, HENRYETTA, OK 74437-5002
(918) 652-4404
(918) 652-4445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6188
OK
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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