Provider Demographics
NPI:1932138831
Name:GIVENS, STEPHEN LESLIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LESLIE
Last Name:GIVENS
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 1:100 ENOCH BLVD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-2229
Mailing Address - Country:US
Mailing Address - Phone:731-925-3220
Mailing Address - Fax:731-925-6139
Practice Address - Street 1:100 ENOCH BLVD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372-2229
Practice Address - Country:US
Practice Address - Phone:731-925-3220
Practice Address - Fax:731-925-6139
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS2949122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist