NPI 1104203611

Liv General and Cosmetic Dentistry

Organisation Preferred Provider Organization The Colony, TX

Practice location

Address: 5101 State Highway 121 STE 200, The Colony, TX 75056-2601
Phone: (607) 237-8376

Authorised official

Name: Clark Wilson Steffens
Title: Owner/Dentist
Phone: (254) 644-2463

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 23907 (TX)

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Registry record

NPI: 1104203611
Entity type: Organization
NPI issued: 4 May 2015
Record last updated: 4 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.