Provider Demographics
NPI:1548456023
Name:DENTISTRY BY DESIGN
Entity type:Organization
Organization Name:DENTISTRY BY DESIGN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-539-2314
Mailing Address - Street 1:1110 WESTPORT DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2859
Mailing Address - Country:US
Mailing Address - Phone:785-539-2314
Mailing Address - Fax:785-539-1121
Practice Address - Street 1:1110 WESTPORT DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2859
Practice Address - Country:US
Practice Address - Phone:785-539-2314
Practice Address - Fax:785-539-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty