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General NPI Number Information
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NPI Number | 1649683335
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Entity Type | Individual
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Provider Name | ERIC DANIEL STEVENS D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 2700 PGA BLVD STE 202
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2958
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Country | US
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Telephone | 561-622-6100
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Fax | 561-622-6107
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Provider Business Mailing Address
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Address Line | 10484 STRINGFELLOW RD STE 3
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City | ST JAMES CITY
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State | FL
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Zip | 33956-3209
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Country | US
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Telephone | 239-283-1041
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Fax | 239-283-1684
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN 20657
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN20657
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License Number State | FL
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