Provider Demographics
NPI:1518020809
Name:ENICH, STEVE G (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:G
Last Name:ENICH
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 1:217 1ST ST NW
Mailing Address - Street 2:PO BOX 632
Mailing Address - City:CHISHOLM
Mailing Address - State:MN
Mailing Address - Zip Code:55719-1701
Mailing Address - Country:US
Mailing Address - Phone:218-254-3311
Mailing Address - Fax:
Practice Address - Street 1:217 1ST ST NW
Practice Address - Street 2:
Practice Address - City:CHISHOLM
Practice Address - State:MN
Practice Address - Zip Code:55719-1701
Practice Address - Country:US
Practice Address - Phone:218-254-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN94671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice