Provider Demographics
NPI:1295956068
Name:DENTAL CENTER OF STEAMBOAT SPRINGS, PLLC
Entity type:Organization
Organization Name:DENTAL CENTER OF STEAMBOAT SPRINGS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:EIVINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-871-4611
Mailing Address - Street 1:940 CENTRAL PARK DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8816
Mailing Address - Country:US
Mailing Address - Phone:970-871-4611
Mailing Address - Fax:970-879-4527
Practice Address - Street 1:940 CENTRAL PARK DR
Practice Address - Street 2:SUITE 210
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8816
Practice Address - Country:US
Practice Address - Phone:970-871-4611
Practice Address - Fax:970-879-4527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO78591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty