Organization
J. STEVEN WIDNER, DDS, PC
Active
Organization
J. STEVEN WIDNER, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES STEVEN WIDNER DDS (PRESIDENT)
(512) 452-3223
Entity
Organization
Contact information
Practice address
1500 W 38TH ST, SUITE 51, AUSTIN, TX 78731-6321
(512) 452-3223
Mailing address
1500 W 38TH ST, SUITE 51, AUSTIN, TX 78731-6321
(512) 452-3223
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
15113
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000653489
UNITED CONCORDIA
TX
01
—
00G36G
BLUE CROSS AND BLUE SHIELD
TX
Enumeration date
06/20/2008
Last updated
09/07/2011
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