Jeffrey R Evanko Dmd LLC
Dentist, General Practice in Medina, OH. Organization (NPI-2).
NPI number1164025623
StatusActive
Last updated in NPPESNov 24, 2020
Details
- NPI
- 1164025623
- Entity type
- Organization (NPI-2)
- Legal business name
- Jeffrey R Evanko Dmd LLC
- Organization subpart
- No
- Enumeration date
- Nov 18, 2020
- Certification date
- Nov 24, 2020
- Last updated
- Nov 24, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Evanko Dental Group Of Medina (Doing Business As)
Practice location
3637 Medina Rd Ste 200Medina, OH 44256-8154
Phone 330-725-6182
Mailing address
3637 Medina Rd Ste 200Medina, OH 44256-8154
Phone 330-725-6182
Authorized official
Jeffrey R Evanko
Owner/ Dentist
3307256182
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