Provider Demographics
NPI:1407898794
Name:STIEWEL, PATRICK BRIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:BRIAN
Last Name:STIEWEL
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 1:111 N BUENA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4369
Mailing Address - Country:US
Mailing Address - Phone:951-658-9486
Mailing Address - Fax:951-658-9480
Practice Address - Street 1:111 N BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4369
Practice Address - Country:US
Practice Address - Phone:951-658-9486
Practice Address - Fax:951-658-9480
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD228481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice