Provider Demographics
NPI:1336213339
Name:BLAND, STEVEN K (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:K
Last Name:BLAND
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 1:1220 12TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-2102
Mailing Address - Country:US
Mailing Address - Phone:953-402-9327
Mailing Address - Fax:
Practice Address - Street 1:1206 W FRONT ST
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-1903
Practice Address - Country:US
Practice Address - Phone:507-373-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10577122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist