# STEVENSON, FAIRCHILD & SURBER OMS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720220015
- **Authorized official:** CHERYL DORRIS (INSURANCE COORDINATOR)
- **Authorized official phone:** (219) 462-9599

## Contact information

- **Practice address:** 911 WALL ST., SUITE C, VALPARAISO, IN 46383-2553
- **Practice address phone:** (219) 462-9599
- **Practice address fax:** (219) 464-0369
- **Mailing address:** 911 WALL ST., SUITE C, VALPARAISO, IN 46383-2553
- **Mailing address phone:** (219) 462-9599
- **Mailing address fax:** (219) 464-0369

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 04/01/2009
- **Last updated:** 07/07/2021