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General NPI Number Information
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NPI Number | 1770738320
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Entity Type | Organization
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Legal Business Name | STEVEN R OWENS, DDS, PC
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | #1 N. CORONADO BLVD. SUITE #C
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City | CLIFTON
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State | AZ
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Zip | 85546
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Country | US
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Telephone | 928-865-2780
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1535
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City | CLIFTON
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State | AZ
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Zip | 85533-1535
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Country | US
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Telephone | 928-865-2780
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN R OWENS
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Credential | D.D.S.
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Telephone | 928-865-2780
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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 | 2541
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License Number State | AZ
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