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General NPI Number Information
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NPI Number | 1225154198
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Entity Type | Individual
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Provider Name | STEVEN BARRY EATON D.D.S., F.A.G.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 2110 FORDEM AVE
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City | MADISON
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State | WI
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Zip | 53704-4610
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Country | US
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Telephone | 608-244-9124
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Fax | 608-244-3992
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Provider Business Mailing Address
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Address Line | 2110 FORDEM AVE
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City | MADISON
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State | WI
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Zip | 53704-4610
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Country | US
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Telephone | 608-244-9124
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Fax | 608-244-3992
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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 | 019017709
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6070
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License Number State | WI
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