MEDICARE: STEVEN C DURR DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3932	OK

General Provider Information

NPI Number	:	1083682413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN C DURR DDS

Provider Business Mailing Address
First Line	:	402-D S. OAKWOOD RD
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703
Country	:	US
Telephone Number	:	580-242-5862
Fax Number	:	580-242-0263

Provider Business Practice Location Address
First Line	:	402-D S. OAKWOOD RD
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703-4945
Country	:	US
Telephone Number	:	580-242-5862
Fax Number	:	580-242-0263

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	07/08/2007

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