Provider Demographics
NPI:1619967551
Name:EVANS, JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
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 1:2206 SPEDALE CT
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-6137
Mailing Address - Country:US
Mailing Address - Phone:615-302-1414
Mailing Address - Fax:615-302-1434
Practice Address - Street 1:2206 SPEDALE CT
Practice Address - Street 2:SUITE 6
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-6137
Practice Address - Country:US
Practice Address - Phone:615-302-1414
Practice Address - Fax:615-302-1434
Is Sole Proprietor?:No
Enumeration Date:2005-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN81811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice