MEDICARE: DR. SCOTT W.W. STEEDMAN 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	122300000X	Dentist	DE00009090	WA

General Provider Information

NPI Number	:	1871635755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT W.W. STEEDMAN DDS

Provider Business Mailing Address
First Line	:	515 HWY 9 NE STE 101
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258
Country	:	US
Telephone Number	:	425-334-4087
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 STATE ROUTE 9 NE STE 101
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-8523
Country	:	US
Telephone Number	:	425-334-4087
Fax Number	:

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/08/2007

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