Provider Demographics
NPI:1548351661
Name:STEVENSON, HOWARD ERIC (DDS)
Entity type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:ERIC
Last Name:STEVENSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:911 WALL ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2553
Mailing Address - Country:US
Mailing Address - Phone:219-462-9599
Mailing Address - Fax:219-464-0369
Practice Address - Street 1:911 WALL ST
Practice Address - Street 2:SUITE C
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2553
Practice Address - Country:US
Practice Address - Phone:219-462-9599
Practice Address - Fax:219-464-0369
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN12008865A1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery