Provider Demographics
NPI:1104096254
Name:JUNKEN, STEVEN CHESTER (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CHESTER
Last Name:JUNKEN
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 623
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47448-0623
Mailing Address - Country:US
Mailing Address - Phone:812-988-2215
Mailing Address - Fax:812-988-9369
Practice Address - Street 1:50 EAST WILLOW STREET
Practice Address - Street 2:SUITE D
Practice Address - City:NASHVILLE
Practice Address - State:IN
Practice Address - Zip Code:47448-0623
Practice Address - Country:US
Practice Address - Phone:812-988-2215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007252A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice