Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 15111 | OH |
Y | 1223D0001X | Dental Public Health | DN014347 | GA |
NPI | 1326165168 |
---|---|
Provider Name | Dr. Stephen Joseph Arthur |
First Address | Bluffton, SC 29909-2060 |
Second Address | Savannah, GA 31406-5098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 11/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0570298 | (05) | OH |
34-1223870 | FED ID TAX (01) | OH |