Provider Demographics
NPI:1609484328
Name:EVANS, FINN T (DMD, RDH)
Entity Type:Individual
Prefix:DR
First Name:FINN
Middle Name:T
Last Name:EVANS
Suffix:
Gender:M
Credentials:DMD, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MIDDLESEX TPKE # 104
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4908
Mailing Address - Country:US
Mailing Address - Phone:781-272-1288
Mailing Address - Fax:
Practice Address - Street 1:54 MIDDLESEX TPKE # 104
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4908
Practice Address - Country:US
Practice Address - Phone:781-272-1288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858749122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist