Provider Demographics
NPI:1114040383
Name:CARD, STEVEN J (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:CARD
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 SIX FORKS RD # B
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-8601
Mailing Address - Country:US
Mailing Address - Phone:919-848-6090
Mailing Address - Fax:
Practice Address - Street 1:6090 SIX FORKS RD # B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-8601
Practice Address - Country:US
Practice Address - Phone:919-848-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72581223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics