Provider Demographics
NPI:1063532257
Name:RABEDEAUX, STEVEN GRANT (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GRANT
Last Name:RABEDEAUX
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 1:104 N 2ND AVE E
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3237
Mailing Address - Country:US
Mailing Address - Phone:641-792-2780
Mailing Address - Fax:641-791-9797
Practice Address - Street 1:104 N 2ND AVE E
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3237
Practice Address - Country:US
Practice Address - Phone:641-792-2780
Practice Address - Fax:641-791-9797
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA69441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice