Provider Demographics
NPI:1437296563
Name:EVANS, ROB EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROB
Middle Name:EUGENE
Last Name:EVANS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E DUSTMAN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-1269
Mailing Address - Country:US
Mailing Address - Phone:260-824-2811
Mailing Address - Fax:260-824-2812
Practice Address - Street 1:116 E DUSTMAN RD
Practice Address - Street 2:SUITE A
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-1269
Practice Address - Country:US
Practice Address - Phone:260-824-2811
Practice Address - Fax:260-824-2812
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007231B1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice