Provider Demographics
NPI:1306063805
Name:STUTSMAN, STEVEN GRAY (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GRAY
Last Name:STUTSMAN
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 1:400 N ST PAUL ST
Mailing Address - Street 2:STE 310
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201
Mailing Address - Country:US
Mailing Address - Phone:214-871-1022
Mailing Address - Fax:214-871-3368
Practice Address - Street 1:400 N ST PAUL ST
Practice Address - Street 2:STE 310
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201
Practice Address - Country:US
Practice Address - Phone:214-871-1022
Practice Address - Fax:214-871-3368
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX131421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice