Provider Demographics
NPI:1023107000
Name:COWGILL, STEVEN DONALD (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DONALD
Last Name:COWGILL
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 1:2019 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4349
Mailing Address - Country:US
Mailing Address - Phone:503-363-9637
Mailing Address - Fax:503-363-3274
Practice Address - Street 1:2019 STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4349
Practice Address - Country:US
Practice Address - Phone:503-363-9637
Practice Address - Fax:503-363-3274
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD64491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice