=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932840485
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVEN H FLATH DDS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2022
-----------------------------------------------------
Last Update Date | 04/06/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1101 S LINCOLN RD
-----------------------------------------------------
City | ESCANABA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49829-2178
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 906-786-5770
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1101 S LINCOLN RD
-----------------------------------------------------
City | ESCANABA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49829-2178
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 906-786-5770
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DENTIST
-----------------------------------------------------
Name | DR. STEVEN H FLATH
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 906-786-5770
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------