# GROESBECK DENTIST PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stevens Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326420779
- **Authorized official:** DR. MICHAEL STEVENS DDS (PRESIDENT)
- **Authorized official phone:** (254) 729-8400

## Contact information

- **Practice address:** 902 W YEAGUA ST, GROESBECK, TX 76642-3526
- **Practice address phone:** (254) 729-8400
- **Practice address fax:** (254) 729-8407
- **Mailing address:** 902 W YEAGUA ST, GROESBECK, TX 76642-3526
- **Mailing address phone:** (254) 729-8400
- **Mailing address fax:** (254) 729-8407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22841 | TX | Yes |

## Other

- **Enumeration date:** 06/22/2015
- **Last updated:** 06/22/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2924334-01 | — | TX |