Provider Demographics
NPI:1083874028
Name:STEVEN F. RECK, DDS, PC
Entity Type:Organization
Organization Name:STEVEN F. RECK, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:RECK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-534-9600
Mailing Address - Street 1:5426 N ACADEMY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3685
Mailing Address - Country:US
Mailing Address - Phone:719-534-9600
Mailing Address - Fax:719-534-0450
Practice Address - Street 1:5426 N ACADEMY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3685
Practice Address - Country:US
Practice Address - Phone:719-534-9600
Practice Address - Fax:719-534-0450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37455893Medicaid
COP00263039Medicare PIN
CO37455893Medicaid