MEDICARE: DR. STEVE A GORMAN 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	DN122973	GA

General Provider Information

NPI Number	:	1538269709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVE A GORMAN DDS

Provider Business Mailing Address
First Line	:	1198 MADO LOOP
Second Line	:
City	:	CHATTAHOOCHEE HILLS
State	:	GA
Zip	:	30268-2494
Country	:	US
Telephone Number	:	612-209-7315
Fax Number	:

Provider Business Practice Location Address
First Line	:	11090 SERENBE LN STE 300
Second Line	:
City	:	CHATTAHOOCHEE HILLS
State	:	GA
Zip	:	30268-2474
Country	:	US
Telephone Number	:	770-771-6422
Fax Number	:

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	05/17/2024

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