Provider Demographics
NPI:1770734964
Name:STEEN, GARY (DDS)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:STEEN
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 1:340 E PALM LN
Mailing Address - Street 2:SUITE # 280
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-4603
Mailing Address - Country:US
Mailing Address - Phone:602-252-2800
Mailing Address - Fax:602-254-8228
Practice Address - Street 1:340 E PALM LN
Practice Address - Street 2:SUITE # 280
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4603
Practice Address - Country:US
Practice Address - Phone:602-252-2800
Practice Address - Fax:602-254-8228
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1576122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist