Provider Demographics
NPI:1821283862
Name:STEPHENS, STUART B (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:B
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 CROP CIRCLE
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-4945
Mailing Address - Country:US
Mailing Address - Phone:405-350-0700
Mailing Address - Fax:405-350-0752
Practice Address - Street 1:1340 CROP CIRCLE
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-4945
Practice Address - Country:US
Practice Address - Phone:405-350-0700
Practice Address - Fax:405-350-0752
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1201223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics