Provider Demographics
NPI:1215387766
Name:KING, EVELYN A (EFDA)
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:A
Last Name:KING
Suffix:
Gender:F
Credentials:EFDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:230 DUNCAN DR
Mailing Address - Street 2:BLD 1440
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31409-5107
Mailing Address - Country:US
Mailing Address - Phone:912-315-5417
Mailing Address - Fax:912-315-5773
Practice Address - Street 1:230 DUNCAN DR
Practice Address - Street 2:BLD 1440
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31409-5107
Practice Address - Country:US
Practice Address - Phone:912-315-5417
Practice Address - Fax:912-315-5773
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant