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NPI 1215155577

NPI 1215155577 : STEVEN A. STEC DDS, PC : GRAND ISLAND, NE

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General NPI Number Information
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    NPI Number           |    1215155577
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    Entity Type          |    Organization 
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    Legal Business Name  |    STEVEN A. STEC DDS, PC 
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Dates
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    Enumeration Date     |    04/23/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    3010 W FAIDLEY AVE 
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    City                 |    GRAND ISLAND
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    State                |    NE
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    Zip                  |    68803-4109
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    Country              |    US
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    Telephone            |    308-382-4440
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    Fax                  |    308-382-9565
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Provider Business Mailing Address
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    Address Line         |    3010 W FAIDLEY AVE 
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    City                 |    GRAND ISLAND
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    State                |    NE
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    Zip                  |    68803-4109
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    Country              |    US
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    Telephone            |    308-382-4440
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    Fax                  |    308-382-9565
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Authorized Official
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    Title or Position    |    DENTIST
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    Name                 |    DR. STEVEN ANDREW STEC 
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    Credential           |    DDS
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    Telephone            |    308-382-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    5133
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    License Number State |    NE
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