Provider Demographics
NPI:1942327697
Name:FACER, STEVEN RYAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RYAN
Last Name:FACER
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 1:7973 N WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-7941
Mailing Address - Country:US
Mailing Address - Phone:208-691-8705
Mailing Address - Fax:
Practice Address - Street 1:602 N CALGARY CT
Practice Address - Street 2:SUITE 301
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854
Practice Address - Country:US
Practice Address - Phone:208-262-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD3855EN1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics