MEDICARE: DR. JOSEPH WILLIAM STEVENS D.D.S

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	12010072A	IN

General Provider Information

NPI Number	:	1386794352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH WILLIAM STEVENS D.D.S

Provider Business Mailing Address
First Line	:	1001 N MAIN ST
Second Line	:	SUIT 2
City	:	NAPPANEE
State	:	IN
Zip	:	46550-1038
Country	:	US
Telephone Number	:	574-773-7979
Fax Number	:	574-773-7292

Provider Business Practice Location Address
First Line	:	1001 N MAIN ST
Second Line	:	SUIT 2
City	:	NAPPANEE
State	:	IN
Zip	:	46550-1038
Country	:	US
Telephone Number	:	574-773-7979
Fax Number	:	574-773-7292

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. JOSEPH WILLIAM STEVENS D.D.S” Practice Location

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