Healthcare Provider Details

I. General information

NPI: 1306113261
Provider Name (Legal Business Name): PETER FREDERICK STEINHAUER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7492 SPRING DR
BOULDER CO
80303-5120
US

IV. Provider business mailing address

7492 SPRING DR
BOULDER CO
80303-5120
US

V. Phone/Fax

Practice location:
  • Phone: 303-499-1278
  • Fax: 303-543-2351
Mailing address:
  • Phone: 303-499-1278
  • Fax: 303-543-2351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3202
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: