Provider Demographics
NPI:1861532616
Name:POWELL, STEVEN EUGENE (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:EUGENE
Last Name:POWELL
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 1:14809 CARLINGFORD WAY
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1846
Mailing Address - Country:US
Mailing Address - Phone:405-752-7072
Mailing Address - Fax:405-307-8250
Practice Address - Street 1:410 24TH AVE SW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5110
Practice Address - Country:US
Practice Address - Phone:405-307-8200
Practice Address - Fax:405-307-8250
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK40611223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics