Healthcare Provider Details

I. General information

NPI: 1518083401
Provider Name (Legal Business Name): STEPHEN L CAVE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9571 W STATE ROAD 56
FRENCH LICK IN
47432-9708
US

IV. Provider business mailing address

PO BOX 151
FRENCH LICK IN
47432-0151
US

V. Phone/Fax

Practice location:
  • Phone: 812-936-2929
  • Fax: 812-936-2992
Mailing address:
  • Phone: 812-936-2929
  • Fax: 812-936-2992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12007591B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: