Individual
STEVEN LAWRENCE UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
107 THREE RIVERS EAST, FORT WAYNE, IN 46802-1311
(260) 426-4438
Mailing address
107 THREE RIVERS EAST, FORT WAYNE, IN 46802-1311
(260) 426-4438
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008044A
IN
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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