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NPI 1558436725

NPI 1558436725 : STEVEN B WALTERS DDS INC : NORTH OLMSTED, OH

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General NPI Number Information
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    NPI Number           |    1558436725
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    Entity Type          |    Organization 
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    Legal Business Name  |    STEVEN B WALTERS DDS INC 
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Dates
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    Enumeration Date     |    11/22/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    26777 LORAIN RD # 614
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    City                 |    NORTH OLMSTED
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    State                |    OH
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    Zip                  |    44070
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    Country              |    US
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    Telephone            |    440-777-2757
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    Fax                  |    440-777-4479
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Provider Business Mailing Address
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    Address Line         |    26777 LORAIN RD # 614
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    City                 |    NORTH OLMSTED
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    State                |    OH
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    Zip                  |    44070
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    Country              |    US
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    Telephone            |    440-777-2757
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    Fax                  |    440-777-4479
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Authorized Official
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    Title or Position    |    OWNER PRESIDENT
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    Name                 |    DR. STEVEN B WALTERS 
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    Credential           |    DDS
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    Telephone            |    440-777-2757
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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       |    
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    License Number State |    
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