Organization
STEVENSON AND COHEN, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D STEVENSON DDS (SECRETARY)
(707) 544-1764
Entity
Organization
Contact information
Practice address
29 ROTARY WAY, VALLEJO, CA 94591-8475
(707) 554-1764
Mailing address
29 ROTARY WAY, VALLEJO, CA 94591-8475
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366540148
ENDODONTIST
CA
01
—
1396843181
ENDODONTIST
CA
Enumeration date
11/02/2011
Last updated
11/02/2011
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