Healthcare Provider Details

I. General information

NPI: 1023084530
Provider Name (Legal Business Name): STEVEN WILLIAM COVINO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5175 COLD SPRING CREAMERY RD
DOYLESTOWN PA
18901
US

IV. Provider business mailing address

11 BLENHEIM DR
DOYLESTOWN PA
18901
US

V. Phone/Fax

Practice location:
  • Phone: 215-489-8869
  • Fax: 215-489-8869
Mailing address:
  • Phone: 215-794-4395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS028872L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: