MEDICARE: STEPHEN W. RATCLIFF STEPHEN RATCLIFF 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	122300000X	Dentist	13125	TX

General Provider Information

NPI Number	:	1265558431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN W. RATCLIFF STEPHEN RATCLIFF DDS

Provider Business Mailing Address
First Line	:	1007 W RANDOL MILL RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-6503
Country	:	US
Telephone Number	:	817-274-7875
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 W RANDOL MILL RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-6503
Country	:	US
Telephone Number	:	817-274-7875
Fax Number	:

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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