Provider Demographics
NPI:1598989410
Name:STEWART & SCHUESSLER ORTHODONTICS, PC
Entity Type:Organization
Organization Name:STEWART & SCHUESSLER ORTHODONTICS, PC
Other - Org Name:STEWART & SCHUESSLER ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:R
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MSD
Authorized Official - Phone:405-624-1005
Mailing Address - Street 1:607 S ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4218
Mailing Address - Country:US
Mailing Address - Phone:405-624-1005
Mailing Address - Fax:405-743-8117
Practice Address - Street 1:607 S ORCHARD ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4218
Practice Address - Country:US
Practice Address - Phone:405-624-1005
Practice Address - Fax:405-743-8117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty