Individual
MR. STEVEN KENT TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
304 WEST LUCAS, CRESTON, IA 50801
(641) 782-4747
(641) 782-8004
Mailing address
304 WEST LUCAS, CRESTON, IA 50801
(641) 782-4747
(641) 782-8004
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
05730
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0064956
—
IA
Enumeration date
11/08/2006
Last updated
07/08/2007
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