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General NPI Number Information
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NPI Number | 1689165680
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Entity Type | Individual
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Provider Name | KELLYE LAUREN SUTHERLAND STEELE DMD, MS
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Gender | Female
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 6710 SPRING STUEBNER RD STE 700
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City | SPRING
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State | TX
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Zip | 77389-5197
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Country | US
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Telephone | 281-791-0043
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CEDAR CV
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City | SPRINGBORO
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State | OH
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Zip | 45066-9475
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Country | US
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Telephone |
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Fax |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 38351
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 38351
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License Number State | TX
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