Provider Demographics
NPI:1275339608
Name:STEVENSON SMILES
Entity type:Organization
Organization Name:STEVENSON SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCRACKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:256-437-2158
Mailing Address - Street 1:43200 US HIGHWAY 72
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:AL
Mailing Address - Zip Code:35772-6702
Mailing Address - Country:US
Mailing Address - Phone:256-437-2158
Mailing Address - Fax:256-437-2230
Practice Address - Street 1:43200 US HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:AL
Practice Address - Zip Code:35772-6702
Practice Address - Country:US
Practice Address - Phone:256-437-2158
Practice Address - Fax:256-437-2230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental