Provider Demographics
NPI:1306870936
Name:PAYNE, STEVEN WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WILLIAM
Last Name:PAYNE
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 1:1100 NORTH COLLEGE AVE.
Mailing Address - Street 2:DEPT. OF VETERANS AFFAIRS - DENTAL SERVICE 160
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703
Mailing Address - Country:US
Mailing Address - Phone:479-444-5042
Mailing Address - Fax:479-587-5963
Practice Address - Street 1:1100 NORTH COLLEGE AVE.
Practice Address - Street 2:DEPT. OF VETERANS AFFAIRS - DENTAL SERVICE 160
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-444-5042
Practice Address - Fax:479-587-5963
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5740122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist