Provider Demographics
NPI:1750498317
Name:ROWAN, STEVEN MARK (DMD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MARK
Last Name:ROWAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 W EL PORTAL DR STE B
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-2850
Mailing Address - Country:US
Mailing Address - Phone:209-383-9300
Mailing Address - Fax:209-383-9303
Practice Address - Street 1:197 W EL PORTAL DR STE B
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2850
Practice Address - Country:US
Practice Address - Phone:209-383-9300
Practice Address - Fax:209-383-9303
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315231223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU27950Medicare UPIN
CADSO315230Medicare ID - Type Unspecified