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Provider Information for 1780931444



DR. JOSEPH DYLAN EVERETT D.D.S.

Gender: MALE

Individual NPI: 1780931444

Calendar Last Updated: 2018-09-18

Details

Name Value
NPI 1780931444
Enumeration Date 2012-08-12
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 6123 79TH ST STE 100
LUBBOCK, TX 79424-8708
United States

Phone: 806-674-7609 | Fax: 806-686-1263
View Map External Link
Primary Practice Address 6123 79TH ST STE 100
LUBBOCK, TX 79424-8708
United States

Phone: 806-686-1262 | Fax:
View Map External Link
Secondary Practice Address 3302 GASTON AVE
DALLAS, TX 75246-2013
United States

Phone: 214-828-8146 | Fax:
View Map External Link

Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist TX 28022
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location