Evans, Keith Allen

Evans, Keith Allen is an sole proprietor health care provider with primary practice located at 113 N Regency Dr , Bloomington IL 61701-3515. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Endodontics. Dental Providers / Endodontics is his primary health care specialty. Evans, Keith Allen can be contacted via phone (309) 661-8900.

Contact Information

Primary practice address
113 N Regency Dr Bloomington IL 61701-3515
Phone: (309) 661-8900
Fax: (309) 661-8118
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 19-025805 Illinois
Dental Providers / Dentist 122300000X 7391 North Carolina
Dental Providers / Endodontics 1223E0200X 021-002108 Illinois

Profile Details

NPI number 1215009923
LBN Legal business name Evans, Keith Allen
Credentials D.M.D., M.S.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2006
Last updated Mar 12th, 2014 - about 11 years ago

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.

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