MEDICARE: DR. CLAUDE ROBERT STEPHENS D.D.S., M.S., P.A.

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	13140	TX

General Provider Information

NPI Number	:	1659394344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAUDE ROBERT STEPHENS D.D.S., M.S., P.A.

Provider Business Mailing Address
First Line	:	511 W WHEATLAND RD
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4515
Country	:	US
Telephone Number	:	972-298-1474
Fax Number	:	972-298-3557

Provider Business Practice Location Address
First Line	:	511 W WHEATLAND RD
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4515
Country	:	US
Telephone Number	:	972-298-1474
Fax Number	:	972-298-3557

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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