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General NPI Number Information
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NPI Number | 1083019582
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Entity Type | Organization
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Legal Business Name | DR JAMES R STEPHENS DDS PC
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 07/02/2015
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Provider Practice Location Address
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Address Line | 400A LONGWOOD AVE
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City | FARMVILLE
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State | VA
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Zip | 23901-1524
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Country | US
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Telephone | 434-392-4021
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Fax |
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Provider Business Mailing Address
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Address Line | 400A LONGWOOD AVE
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City | FARMVILLE
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State | VA
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Zip | 23901-1524
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES RAY STEPHENS
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Credential |
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Telephone | 434-392-4021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401413182
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License Number State | VA
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