Provider Demographics
NPI:1083847131
Name:STEVEN F. KAMMEYER D.D.S. INC
Entity Type:Organization
Organization Name:STEVEN F. KAMMEYER D.D.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS/PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:KAMMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-293-4510
Mailing Address - Street 1:501 W WETMORE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-1521
Mailing Address - Country:US
Mailing Address - Phone:520-293-4510
Mailing Address - Fax:520-887-8313
Practice Address - Street 1:501 W WETMORE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1521
Practice Address - Country:US
Practice Address - Phone:520-293-4510
Practice Address - Fax:520-887-8313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ25131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty