MEDICARE: DR. STEVEN DICKENS D.D.S., M.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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	7598	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710073168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN DICKENS D.D.S., M.S.

Provider Business Mailing Address
First Line	:	115 BASNIGHT LN
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-2309
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 ATRIUM DR
Second Line	:	SUITE 301
City	:	RALEIGH
State	:	NC
Zip	:	27607-6452
Country	:	US
Telephone Number	:	919-782-9560
Fax Number	:

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. STEVEN DICKENS D.D.S., M.S.” Practice Location

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