Provider Demographics
NPI:1457878019
Name:FRANK J EVANS, DDS, PLLC
Entity Type:Organization
Organization Name:FRANK J EVANS, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PLLC
Authorized Official - Phone:918-478-2341
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:FORT GIBSON
Mailing Address - State:OK
Mailing Address - Zip Code:74434-0206
Mailing Address - Country:US
Mailing Address - Phone:918-478-2341
Mailing Address - Fax:918-478-2341
Practice Address - Street 1:802 S LEE ST
Practice Address - Street 2:
Practice Address - City:FORT GIBSON
Practice Address - State:OK
Practice Address - Zip Code:74434-8709
Practice Address - Country:US
Practice Address - Phone:918-478-3160
Practice Address - Fax:918-478-3160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty