Organization
GROESBECK DENTIST PLLC
Active
Other names
Stevens Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL STEVENS DDS (PRESIDENT)
(254) 729-8400
Entity
Organization
Contact information
Practice address
902 W YEAGUA ST, GROESBECK, TX 76642-3526
(254) 729-8400
(254) 729-8407
Mailing address
902 W YEAGUA ST, GROESBECK, TX 76642-3526
(254) 729-8400
(254) 729-8407
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22841
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2924334-01
—
TX
Enumeration date
06/22/2015
Last updated
06/22/2015
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