Provider Demographics
NPI:1093857617
Name:OFILI, EVELYN (DMD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:OFILI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 S TRUMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-3713
Mailing Address - Country:US
Mailing Address - Phone:636-937-6965
Mailing Address - Fax:636-937-8607
Practice Address - Street 1:860 S TRUMAN BLVD
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-3713
Practice Address - Country:US
Practice Address - Phone:636-937-6965
Practice Address - Fax:636-937-8607
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002016553122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist