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NPI Code Detail

MEDICARE: STEVEN CORNELIUS PRICE D.D.S

MEDICARE: STEVEN CORNELIUS PRICE 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
1122300000XDentistD8515MN

General Provider Information

NPI Number : 1467600544
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN CORNELIUS PRICE D.D.S
Provider Business Mailing Address
First Line : 693 DECORAH LN
Second Line :
City : MENDOTA HEIGHTS
State : MN
Zip : 55120-1672
Country : US
Telephone Number : 651-454-7573
Fax Number :
Provider Business Practice Location Address
First Line : 478 ROBERT ST S
Second Line :
City : SAINT PAUL
State : MN
Zip : 55107-2236
Country : US
Telephone Number : 651-602-7575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2008
Last Update Date : 09/03/2008

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Directions to “ STEVEN CORNELIUS PRICE D.D.S” Practice Location

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