Provider Demographics
NPI:1023410974
Name:TRAVIS R STERNER DDS PLLC
Entity type:Organization
Organization Name:TRAVIS R STERNER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:STERNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-449-2081
Mailing Address - Street 1:156 BARKER RD
Mailing Address - Street 2:PO BOX 339
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-9507
Mailing Address - Country:US
Mailing Address - Phone:734-449-2081
Mailing Address - Fax:734-449-2083
Practice Address - Street 1:156 BARKER RD
Practice Address - Street 2:
Practice Address - City:WHITMORE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48189-9507
Practice Address - Country:US
Practice Address - Phone:734-449-2081
Practice Address - Fax:734-449-2083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010192941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty