Provider Demographics
NPI:1780731216
Name:STEYAERT, FRANCIS CHARLES (DDS MSD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:CHARLES
Last Name:STEYAERT
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:ACL INDIAN HOSPITAL ATTN BUS OFFICE
Mailing Address - City:SAN FIDEL
Mailing Address - State:NM
Mailing Address - Zip Code:87049
Mailing Address - Country:US
Mailing Address - Phone:719-596-2830
Mailing Address - Fax:
Practice Address - Street 1:I40 EXIT 102 HALF MI SOUTH
Practice Address - Street 2:ACL HOSPITAL DENTAL CLINIC
Practice Address - City:SAN FIDEL
Practice Address - State:NM
Practice Address - Zip Code:87049
Practice Address - Country:US
Practice Address - Phone:505-552-5310
Practice Address - Fax:505-552-5460
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD1004441223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMH3451Medicaid
NMH3451Medicaid