Provider Demographics
NPI:1417935545
Name:ECHOLS, STEVEN R (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:ECHOLS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4913 FIVE POINTS JEWELL RD
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:GA
Mailing Address - Zip Code:30820-7905
Mailing Address - Country:US
Mailing Address - Phone:706-465-0315
Mailing Address - Fax:706-864-0315
Practice Address - Street 1:2467 GOLDEN CAMP RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-5515
Practice Address - Country:US
Practice Address - Phone:706-790-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA DN009155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA600198624IMedicaid