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General NPI Number Information
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NPI Number | 1598160624
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Entity Type | Organization
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Legal Business Name | BRIAN STIEWEL DDS INC
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Dates
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Enumeration Date | 10/31/2014
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 111 N BUENA VISTA ST
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City | HEMET
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State | CA
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Zip | 92543-4369
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Country | US
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Telephone | 951-658-9486
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Fax | 951-658-9480
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Provider Business Mailing Address
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Address Line | 111 N BUENA VISTA ST
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City | HEMET
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State | CA
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Zip | 92543-4369
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Country | US
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Telephone | 951-658-9486
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Fax | 951-658-9480
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICK BRIAN STIEWEL
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Credential | DDS
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Telephone | 951-658-9486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | D22848
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License Number State | CA
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