Provider Demographics
NPI:1194095786
Name:STEVEN DICKENS DDS, MS, PA
Entity type:Organization
Organization Name:STEVEN DICKENS DDS, MS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPAULDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-845-0600
Mailing Address - Street 1:1326 MATTHEWS TOWNSHIP PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4600
Mailing Address - Country:US
Mailing Address - Phone:704-845-0600
Mailing Address - Fax:704-849-2542
Practice Address - Street 1:1326 MATTHEWS TOWNSHIP PARKWAY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4600
Practice Address - Country:US
Practice Address - Phone:704-845-0600
Practice Address - Fax:794-849-2542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty