Provider Demographics
NPI:1538210851
Name:STEENBERGH, OMAR FLOYD III (DDS)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:FLOYD
Last Name:STEENBERGH
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:OMAR
Other - Middle Name:F
Other - Last Name:STEENBERGHDDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:15275 E 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-2700
Mailing Address - Country:US
Mailing Address - Phone:586-296-3230
Mailing Address - Fax:586-296-3231
Practice Address - Street 1:15275 E 13 MILE RD
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-2700
Practice Address - Country:US
Practice Address - Phone:586-296-3230
Practice Address - Fax:586-296-3231
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010138291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice