=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578904660
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVEN S. SABATINO DDS, MS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2013
-----------------------------------------------------
Last Update Date | 07/17/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16620 N 40TH ST SUITE A-1
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85032-3348
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-485-4700
-----------------------------------------------------
Fax | 602-485-4720
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16620 N 40TH ST SUITE A-1
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85032-3348
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-485-4700
-----------------------------------------------------
Fax | 602-485-4720
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ORTHODONTIST/OWNER
-----------------------------------------------------
Name | DR. STEVEN S STOWE
-----------------------------------------------------
Credential | DDS, MS
-----------------------------------------------------
Telephone | 602-485-4700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------