Evans, Thomas William

Evans, Thomas William is an sole proprietor health care provider with primary practice located at 740 Pennsylvania Ave , Ottumwa IA 52501-2152. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Evans, Thomas William can be contacted via phone (641) 683-1000.

Contact Information

Primary practice address
740 Pennsylvania Ave Ottumwa IA 52501-2152
Phone: (641) 683-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 6354 Iowa

Profile Details

NPI number 1083721211
LBN Legal business name Evans, Thomas William
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2006
Last updated Jul 9th, 2007 - about 19 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 1083721211 NPPES
Iowa MEDICAID 0169144

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