| Randolph T. Evans, D.d.s. P.l.l.c. | |
|
22 Sierra Drive Martinsburg WV 25403-1133 | |
| (304) 263-3131 | |
| (304) 263-4493 |
| Full Name | Randolph T. Evans, D.d.s. P.l.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 22 Sierra Drive, Martinsburg, West Virginia |
| Authorized Official Name and Position | Randolph Terry Evans (OWNER) |
| Authorized Official Contact | 3042633131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randolph T. Evans, D.d.s. P.l.l.c. 22 Sierra Drive Martinsburg WV 25403-1133 Ph: (304) 263-3131 | Randolph T. Evans, D.d.s. P.l.l.c. 22 Sierra Drive Martinsburg WV 25403-1133 Ph: (304) 263-3131 |
| NPI Number | 1902026479 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902026479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2987 (West Virginia) | Primary |
| 1223G0001X | Dentist - General Practice | 3708 (West Virginia) | Secondary |
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