Provider Demographics
NPI:1184815664
Name:SORENSEN, STEVE ERIC (DDS,MS)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:ERIC
Last Name:SORENSEN
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 1:4587 CEDAR HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILLS
Mailing Address - State:UT
Mailing Address - Zip Code:84062-8826
Mailing Address - Country:US
Mailing Address - Phone:801-756-2006
Mailing Address - Fax:
Practice Address - Street 1:4587 CEDAR HILLS DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILLS
Practice Address - State:UT
Practice Address - Zip Code:84062-8826
Practice Address - Country:US
Practice Address - Phone:801-756-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6456209-8903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist