Provider Demographics
NPI:1649269382
Name:ECKLUND, STEVE BLAINE (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:BLAINE
Last Name:ECKLUND
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 1:903 N ALPHA ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4362
Mailing Address - Country:US
Mailing Address - Phone:308-382-2964
Mailing Address - Fax:
Practice Address - Street 1:903 N ALPHA ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4362
Practice Address - Country:US
Practice Address - Phone:308-382-2964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-16
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE52551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice