Healthcare Provider Details

I. General information

NPI: 1881692556
Provider Name (Legal Business Name): DAVID R STEINER DDS MSD PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 SOUTH 19TH ST., SUITE 102
TACOMA WA
98405-1462
US

IV. Provider business mailing address

4050 SOUTH 19TH ST., SUITE 102
TACOMA WA
98405-1462
US

V. Phone/Fax

Practice location:
  • Phone: 253-752-5511
  • Fax: 253-756-5875
Mailing address:
  • Phone: 253-752-5511
  • Fax: 253-756-5875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDE00004005
License Number StateWA

VIII. Authorized Official

Name: DAVID ROBERT STEINER
Title or Position: PRESIDENT
Credential: DDS, MSD
Phone: 253-752-5511