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General NPI Number Information
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NPI Number | 1902355357
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Entity Type | Organization
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Legal Business Name | MICHAEL G. STEVENS DDS, PC
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Dates
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Enumeration Date | 09/27/2016
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 2225 BROADWATER AVE STE 1
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City | BILLINGS
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State | MT
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Zip | 59102-4707
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Country | US
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Telephone | 406-656-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 2225 BROADWATER AVE STE 1
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City | BILLINGS
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State | MT
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Zip | 59102-4707
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Country | US
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Telephone | 406-656-8300
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CATHY ANN MCKINLEY
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Credential |
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Telephone | 406-656-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 1715
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License Number State | MT
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