Provider Demographics
NPI:1053392563
Name:ROLON, EVELYN M (DMD)
Entity type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:M
Last Name:ROLON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:363 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-3809
Mailing Address - Country:US
Mailing Address - Phone:276-739-7942
Mailing Address - Fax:276-739-7943
Practice Address - Street 1:465 WEST MAIN
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210
Practice Address - Country:US
Practice Address - Phone:276-739-7942
Practice Address - Fax:276-739-7943
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014109011223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry