MEDICARE: STEVEN M. DOERING DMD, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	10170	NC

General Provider Information

NPI Number	:	1063917623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN M. DOERING DMD, PLLC

Provider Business Mailing Address
First Line	:	3118 N CROATAN HWY STE 102
Second Line	:
City	:	KILL DEVIL HILLS
State	:	NC
Zip	:	27948-9254
Country	:	US
Telephone Number	:	252-441-5811
Fax Number	:	252-441-2233

Provider Business Practice Location Address
First Line	:	3118 N CROATAN HWY STE 102
Second Line	:
City	:	KILL DEVIL HILLS
State	:	NC
Zip	:	27948-9254
Country	:	US
Telephone Number	:	252-441-5811
Fax Number	:	252-441-2233

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	STEVEN M DOERING
Credential	:	DMD
Telephone Number	:	252-441-5811

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	03/27/2018

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