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General NPI Number Information
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NPI Number | 1134789316
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Entity Type | Individual
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Provider Name | STEVEN DAVID MAGURA DDS
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Gender | Male
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 2001 ROOSEVELT RD
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City | VALPARAISO
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State | IN
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Zip | 46383-2746
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Country | US
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Telephone | 219-464-9911
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Fax |
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Provider Business Mailing Address
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Address Line | 590 KELDON CT
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City | VALPARAISO
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State | IN
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Zip | 46385-6804
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Country | US
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Telephone | 219-929-7735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12013184A
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License Number State | IN
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