Organization
CONVENIENT DENTAL SPECIALISTS BENNETT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PATRICK EVANSON DDS (OWNER)
(801) 580-6877
Entity
Organization
Contact information
Practice address
280 E COLFAX AVE, BENNETT, CO 80102-5003
Mailing address
PO BOX 514, BENNETT, CO 80102-0514
(801) 580-6877
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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