Provider Demographics
NPI:1689054124
Name:MATTHEW EVERS, DMD, LLC
Entity Type:Organization
Organization Name:MATTHEW EVERS, DMD, LLC
Other - Org Name:EVERS DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-489-5745
Mailing Address - Street 1:1500 W FLOYD BAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29341-1204
Mailing Address - Country:US
Mailing Address - Phone:864-489-5745
Mailing Address - Fax:
Practice Address - Street 1:1500 W FLOYD BAKER BLVD
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29341-1204
Practice Address - Country:US
Practice Address - Phone:864-489-5745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-30
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty