Provider Demographics
NPI:1881612273
Name:BEVANS, DAVID
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:BEVANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7889 S LINCOLN CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2651
Mailing Address - Country:US
Mailing Address - Phone:303-798-1454
Mailing Address - Fax:
Practice Address - Street 1:7889 S LINCOLN CT
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2651
Practice Address - Country:US
Practice Address - Phone:303-798-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1045041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice