Evans Endodontics, P.c. | |
208 N Williamsburg Dr Bloomington IL 61704-3571 | |
(309) 661-8900 | |
(309) 661-8118 |
Full Name | Evans Endodontics, P.c. |
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Speciality | Dentist - Endodontics |
Location | 208 N Williamsburg Dr, Bloomington, Illinois |
Authorized Official Name and Position | Keith Allen Evans (PRESIDENT) |
Authorized Official Contact | 3096618900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Evans Endodontics, P.c. 208 N Williamsburg Dr Bloomington IL 61704-3571 Ph: (309) 661-8900 | Evans Endodontics, P.c. 208 N Williamsburg Dr Bloomington IL 61704-3571 Ph: (309) 661-8900 |
NPI Number | 1245415348 |
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Provider Enumeration Date | 01/08/2008 |
Last Update Date | 01/08/2008 |
Identifier | Type | State | Issuer |
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1245415348 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223E0200X | Dentist - Endodontics | 21002108 (Illinois) | Primary |
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