Provider Demographics
NPI:1184796849
Name:EVANS, KURT G (DMD)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:G
Last Name:EVANS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1012
Mailing Address - Country:US
Mailing Address - Phone:724-285-7202
Mailing Address - Fax:724-282-1392
Practice Address - Street 1:103 EVANS CITY RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2601
Practice Address - Country:US
Practice Address - Phone:724-285-7202
Practice Address - Fax:724-282-1392
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021536L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice