Provider Demographics
NPI:1700804952
Name:STEVENS, STERLING REED (DDS)
Entity Type:Individual
Prefix:DR
First Name:STERLING
Middle Name:REED
Last Name:STEVENS
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 1:202 EAST 3RD AVUNUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:CAVALIER
Mailing Address - State:ND
Mailing Address - Zip Code:58220
Mailing Address - Country:US
Mailing Address - Phone:701-265-8777
Mailing Address - Fax:
Practice Address - Street 1:202 E 3RD AVE S
Practice Address - Street 2:
Practice Address - City:CAVALIER
Practice Address - State:ND
Practice Address - Zip Code:58220-4023
Practice Address - Country:US
Practice Address - Phone:701-265-8777
Practice Address - Fax:701-265-8777
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO87771223G0001X
ND21001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice