MEDICARE: DR. STEVEN ARNOLD ENEA DDS

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	122300000X	Dentist	6402	CO

General Provider Information

NPI Number	:	1376515478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN ARNOLD ENEA DDS

Provider Business Mailing Address
First Line	:	1975 DOMINION WAY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1481
Country	:	US
Telephone Number	:	719-388-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1975 DOMINION WAY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1481
Country	:	US
Telephone Number	:	719-388-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	07/08/2007

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