Provider Demographics
NPI:1467580548
Name:FOOSHEE, STEVEN WARREN (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:WARREN
Last Name:FOOSHEE
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 1:135 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-7640
Mailing Address - Country:US
Mailing Address - Phone:918-245-0229
Mailing Address - Fax:918-245-4205
Practice Address - Street 1:135 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7640
Practice Address - Country:US
Practice Address - Phone:918-245-0229
Practice Address - Fax:918-245-4205
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK38411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice