Provider Demographics
NPI:1134381809
Name:STEVEN M DEATON, DDS, PC
Entity type:Organization
Organization Name:STEVEN M DEATON, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEATON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-326-9631
Mailing Address - Street 1:1305 E KIRK ST
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:OK
Mailing Address - Zip Code:74743-3601
Mailing Address - Country:US
Mailing Address - Phone:580-326-9631
Mailing Address - Fax:580-326-5440
Practice Address - Street 1:1305 E KIRK ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-3601
Practice Address - Country:US
Practice Address - Phone:580-326-9631
Practice Address - Fax:580-326-5440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5107122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty