Individual
DR. DWAYNE E EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4927 LAKERIDGE PKWY, STE 130, GRAND PRAIRIE, TX 75052-3087
(972) 602-1935
Mailing address
4927 LAKERIDGE PKWY, STE 130, GRAND PRAIRIE, TX 75052-3087
(972) 602-1935
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16342
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16342
TEXAS DENTAL BOARD
TX
Enumeration date
07/08/2009
Last updated
06/06/2011
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