Provider Demographics
NPI:1811081276
Name:GATTEN, STEVEN THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:THOMAS
Last Name:GATTEN
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 1:2201 N GOVERNMENT WAY
Mailing Address - Street 2:SUITE G
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3658
Mailing Address - Country:US
Mailing Address - Phone:208-664-9129
Mailing Address - Fax:208-664-9120
Practice Address - Street 1:2201 N GOVERNMENT WAY
Practice Address - Street 2:SUITE G
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-3658
Practice Address - Country:US
Practice Address - Phone:208-664-9129
Practice Address - Fax:208-664-9120
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-16361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice