Provider Demographics
NPI:1790866622
Name:OUWINGA, STEVEN ROSS (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ROSS
Last Name:OUWINGA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2515 5TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-1204
Mailing Address - Country:US
Mailing Address - Phone:906-786-6533
Mailing Address - Fax:906-786-6591
Practice Address - Street 1:2515 5TH AVE S
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1204
Practice Address - Country:US
Practice Address - Phone:906-786-6533
Practice Address - Fax:906-786-6591
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI180361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics