Provider Demographics
NPI:1225286636
Name:EVANS, TAMARA NICOLE (DDS)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:NICOLE
Last Name:EVANS
Suffix:
Gender:F
Credentials:DDS
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Other - Credentials:
Mailing Address - Street 1:1500 MOUNT ZION PL
Mailing Address - Street 2:SUITE B
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-3254
Mailing Address - Country:US
Mailing Address - Phone:336-748-0033
Mailing Address - Fax:336-748-0414
Practice Address - Street 1:108 PICCADILLY DR STE B
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-3526
Practice Address - Country:US
Practice Address - Phone:336-837-3934
Practice Address - Fax:336-518-0416
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2024-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC8368122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist