Provider Demographics
NPI:1447320619
Name:EVERS, G. BRENT (DDS)
Entity type:Individual
Prefix:DR
First Name:G.
Middle Name:BRENT
Last Name:EVERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5815 NW BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1494
Mailing Address - Country:US
Mailing Address - Phone:816-741-2333
Mailing Address - Fax:816-741-3888
Practice Address - Street 1:5815 NW BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1494
Practice Address - Country:US
Practice Address - Phone:816-741-2333
Practice Address - Fax:816-741-3888
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE15176122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist