Provider Demographics
NPI:1215108352
Name:STEVEN M AUSTIN DDS PA
Entity type:Organization
Organization Name:STEVEN M AUSTIN DDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ORTHODONTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-735-1606
Mailing Address - Street 1:701 S LAUREL ST
Mailing Address - Street 2:STE 1
Mailing Address - City:LINCOLNTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28092
Mailing Address - Country:US
Mailing Address - Phone:704-735-1606
Mailing Address - Fax:704-732-8772
Practice Address - Street 1:701 S LAUREL ST
Practice Address - Street 2:STE 1
Practice Address - City:LINCOLNTOWN
Practice Address - State:NC
Practice Address - Zip Code:28092
Practice Address - Country:US
Practice Address - Phone:704-735-1606
Practice Address - Fax:704-732-8772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC63121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty