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General NPI Number Information
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NPI Number | 1891181343
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Entity Type | Organization
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Legal Business Name | STEEL ORAL AND MAXILLOFACIAL SURGERY INC
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Dates
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Enumeration Date | 04/11/2015
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Last Update Date | 12/24/2017
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Provider Practice Location Address
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Address Line | 915 MESA ROJA TRL NE
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City | RIO RANCHO
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State | NM
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Zip | 87124-6388
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Country | US
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Telephone | 801-372-6123
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Fax |
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Provider Business Mailing Address
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Address Line | 915 MESA ROJA TRL NE
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City | RIO RANCHO
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State | NM
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Zip | 87124-6388
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Country | US
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Telephone | 801-372-6123
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DREW STEEL
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Credential |
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Telephone | 801-372-6123
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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 | DD4263
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License Number State | NM
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