Provider Demographics
NPI:1053349514
Name:PRACHT, STEVEN D (DDS, PC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:PRACHT
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:OK
Mailing Address - Zip Code:73052-5212
Mailing Address - Country:US
Mailing Address - Phone:405-756-4093
Mailing Address - Fax:405-756-4093
Practice Address - Street 1:102 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:OK
Practice Address - Zip Code:73052-5212
Practice Address - Country:US
Practice Address - Phone:405-756-4093
Practice Address - Fax:405-756-4093
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK41301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice