Provider Demographics
NPI:1053453233
Name:COMFORT DENTAL INC
Entity Type:Organization
Organization Name:COMFORT DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEPUTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-256-2525
Mailing Address - Street 1:747 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2368
Mailing Address - Country:US
Mailing Address - Phone:417-256-2525
Mailing Address - Fax:417-256-7546
Practice Address - Street 1:747 W BROADWAY
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2368
Practice Address - Country:US
Practice Address - Phone:417-256-2525
Practice Address - Fax:417-256-7546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002018999122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty