Provider Demographics
NPI:1114979523
Name:DENBROCK, STEPHEN ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALLEN
Last Name:DENBROCK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 N ORACLE RD
Mailing Address - Street 2:SUITE 238
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7732
Mailing Address - Country:US
Mailing Address - Phone:520-297-6343
Mailing Address - Fax:520-297-9003
Practice Address - Street 1:6700 N ORACLE RD
Practice Address - Street 2:SUITE 238
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7732
Practice Address - Country:US
Practice Address - Phone:520-297-6343
Practice Address - Fax:520-297-9003
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46121223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery