Individual
DR. STEVEN A SKOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3996 N FRONTAGE RD, FAYETTEVILLE, AR 72703-5122
(479) 582-3002
(479) 582-2840
Mailing address
PO BOX 4185, FAYETTEVILLE, AR 72702-4185
(479) 717-1171
(479) 582-2840
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2826
AR
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2826
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136420679
—
AR
01
—
234282400
DEPT OF LABOR WORKERS COM
AR
01
—
58187
BCBS
AR
01
—
985779
UNITED CONCORDIA
AR
Enumeration date
01/05/2007
Last updated
06/07/2022
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