Provider Demographics
NPI:1174830079
Name:STEVEN E GARRETT DDS PA
Entity Type:Organization
Organization Name:STEVEN E GARRETT DDS PA
Other - Org Name:HILLSBOROUGH FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-644-7400
Mailing Address - Street 1:101 E CORBIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2272
Mailing Address - Country:US
Mailing Address - Phone:919-644-7400
Mailing Address - Fax:
Practice Address - Street 1:101 E CORBIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2272
Practice Address - Country:US
Practice Address - Phone:919-644-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC85761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910527Medicaid