Evans, Brian David
Evans, Brian David is an sole proprietor health care provider with primary practice located at Uss Carl Vinson Cvn70 Unit 1000111 Box 1770, Fpo AP 96629. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Evans, Brian David can be contacted via phone (619) 545-4814.Contact Information
Primary practice address
Uss Carl Vinson Cvn70 Unit 1000111 Box 1770
Fpo AP 96629
Phone: (619) 545-4814
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 61230 | California |
Profile Details
| NPI number | 1114229317 |
|---|---|
| LBN Legal business name | Evans, Brian David |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 22nd, 2010 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114229317 | NPPES |
| Other | GA1863 | GENERAL ANESTHESIA PERMIT | |
| Other | 61230 | GENERAL ANESTHESIA PERMIT |
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