Provider Demographics
NPI:1316084585
Name:GARNER, STEPHEN S (DMD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:S
Last Name:GARNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7945 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-8602
Mailing Address - Country:US
Mailing Address - Phone:928-317-1900
Mailing Address - Fax:928-317-1900
Practice Address - Street 1:7945 E 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-8602
Practice Address - Country:US
Practice Address - Phone:928-317-1900
Practice Address - Fax:928-317-1900
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ69491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice