Organization
STEPHENS & STEPHENS ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN G STEPHENS JR. D.D.S., M.S.D. (CO-OWNER)
(903) 561-7861
Entity
Organization
Contact information
Practice address
3707 BROOKSIDE DRIVE, TYLER, TX 75701-8699
(903) 561-7861
(903) 561-2431
Mailing address
3707 BROOKSIDE DRIVE, TYLER, TX 75701-8699
(903) 561-7861
(903) 561-2431
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
20671
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9636
TX
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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