Evans, Jacqueline

Evans, Jacqueline is an individual health care provider with primary practice located at 37944 Church Ave , Dade City FL 33525-4207. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Evans, Jacqueline can be contacted via phone (352) 518-2000.

Contact Information

Primary practice address
37944 Church Ave Dade City FL 33525-4207
Phone: (352) 518-2000
Fax: (352) 567-5193
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X DH10640 Florida

Profile Details

NPI number 1255602660
LBN Legal business name Evans, Jacqueline
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2012
Last updated Jan 17th, 2012 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1255602660 NPPES
Florida Other DH10640 LICENSE

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