Provider Demographics
NPI:1538389465
Name:OWENS, STEVEN RALPH (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RALPH
Last Name:OWENS
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:PO BOX 1535
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:AZ
Mailing Address - Zip Code:85533-1535
Mailing Address - Country:US
Mailing Address - Phone:928-865-2780
Mailing Address - Fax:928-865-3482
Practice Address - Street 1:#1 N. CORONADO BLVD.
Practice Address - Street 2:SUITE C
Practice Address - City:CLIFTON
Practice Address - State:AZ
Practice Address - Zip Code:85533
Practice Address - Country:US
Practice Address - Phone:928-865-2780
Practice Address - Fax:928-865-3482
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2541122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist