Provider Demographics
NPI:1801267307
Name:STEVE SHIVER DMD PC
Entity type:Organization
Organization Name:STEVE SHIVER DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-745-3268
Mailing Address - Street 1:1709 PEPPERELL PKWY
Mailing Address - Street 2:1709 PEPPERELL PARKWAY
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5548
Mailing Address - Country:US
Mailing Address - Phone:334-745-3268
Mailing Address - Fax:334-745-6360
Practice Address - Street 1:1709 PEPPERELL PKWY
Practice Address - Street 2:1709 PEPPERELL PARKWAY
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5548
Practice Address - Country:US
Practice Address - Phone:334-745-3268
Practice Address - Fax:334-745-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-10
Last Update Date:2015-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3702122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty