Organization
BLOCK & STEVENSON OMS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD ERIC STEVENSON DDS (SECRETARY)
(219) 462-9599
Entity
Organization
Contact information
Practice address
911 WALL ST, SUITE C, VALPARAISO, IN 46383-2553
(219) 462-9599
(219) 464-0369
Mailing address
911 WALL ST, SUITE C, VALPARAISO, IN 46383-2553
(219) 462-9599
(219) 464-0369
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12007573A
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
12008865A
IN
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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