Provider Demographics
NPI:1639276603
Name:STEVEN PASCOE, DDS, PA
Entity Type:Organization
Organization Name:STEVEN PASCOE, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:PASCOE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-327-6529
Mailing Address - Street 1:PO BOX 1449
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033-1449
Mailing Address - Country:US
Mailing Address - Phone:501-327-6529
Mailing Address - Fax:501-327-8695
Practice Address - Street 1:95 BEAVERFORK RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-9517
Practice Address - Country:US
Practice Address - Phone:501-327-6529
Practice Address - Fax:501-327-8695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR30021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR=========OtherTAX ID