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General NPI Number Information
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NPI Number | 1205017761
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Entity Type | Organization
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Legal Business Name | GORDON J STEUCK DDS MSD INC
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 1062 CASS ST
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City | MONTEREY
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State | CA
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Zip | 93940-4509
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Country | US
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Telephone | 831-373-2128
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Fax | 831-373-2128
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Provider Business Mailing Address
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Address Line | 1062 CASS ST
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City | MONTEREY
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State | CA
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Zip | 93940-4509
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Country | US
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Telephone | 831-373-2128
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Fax | 831-373-5579
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Authorized Official
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Title or Position | OWNER
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Name | GORDON J STEUCK
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Credential | DDS MSD
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Telephone | 831-373-2128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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