Provider Demographics
NPI:1760548457
Name:LAW, STEPHEN K (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:K
Last Name:LAW
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 1:4050 HEALTHWAY DR STE 240
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-8185
Mailing Address - Country:US
Mailing Address - Phone:630-692-7900
Mailing Address - Fax:630-692-7901
Practice Address - Street 1:4050 HEALTHWAY DR STE 240
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8185
Practice Address - Country:US
Practice Address - Phone:630-692-7900
Practice Address - Fax:630-692-7901
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice