Provider Demographics
NPI:1487731295
Name:STRANGE, STEVEN DWAIN (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DWAIN
Last Name:STRANGE
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 1:709 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3936
Mailing Address - Country:US
Mailing Address - Phone:405-341-4040
Mailing Address - Fax:405-285-6841
Practice Address - Street 1:709 S BROADWAY
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3936
Practice Address - Country:US
Practice Address - Phone:405-341-4040
Practice Address - Fax:405-285-6841
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK56151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice