Dierickx, Steven Raymond
Dierickx, Steven Raymond is an individual health care provider with primary practice located at 2031 Hawthorne St Suite G, Forest Grove OR 97116-1700. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Dierickx, Steven Raymond can be contacted via phone (503) 357-2171.Contact Information
Primary practice address
2031 Hawthorne St Suite G
Forest Grove OR 97116-1700
Phone: (503) 357-2171
Fax: (503) 357-2172
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 4924 | Oregon |
Profile Details
| NPI number | 1629032255 |
|---|---|
| LBN Legal business name | Dierickx, Steven Raymond |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629032255 | NPPES |
| Oregon | Other | 4924 | LICENSE NUMBER |
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