Provider Demographics
NPI:1821209727
Name:SESSOM, STEVEN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:SESSOM
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:PO BOX 1002
Mailing Address - Street 2:
Mailing Address - City:OZONA
Mailing Address - State:TX
Mailing Address - Zip Code:76943-1002
Mailing Address - Country:US
Mailing Address - Phone:325-392-2575
Mailing Address - Fax:325-392-3584
Practice Address - Street 1:304 AVE D
Practice Address - Street 2:
Practice Address - City:OZONA
Practice Address - State:TX
Practice Address - Zip Code:76943-1002
Practice Address - Country:US
Practice Address - Phone:325-392-2575
Practice Address - Fax:325-392-3584
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice