Provider Demographics
NPI:1801842711
Name:STEVES, RICHARD A (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:STEVES
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 1:983 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CORRY
Mailing Address - State:PA
Mailing Address - Zip Code:16407-1228
Mailing Address - Country:US
Mailing Address - Phone:814-664-4011
Mailing Address - Fax:814-664-9376
Practice Address - Street 1:983 N CENTER ST
Practice Address - Street 2:
Practice Address - City:CORRY
Practice Address - State:PA
Practice Address - Zip Code:16407-1228
Practice Address - Country:US
Practice Address - Phone:814-664-4011
Practice Address - Fax:814-664-9376
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO1911OL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005303010002OtherMEDICAL ASSISTANCE
PA1771107OtherUNITED CONCORDIA