Provider Demographics
NPI:1073731451
Name:HART, STEVEN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:HART
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 1:1500 W 3RD AVE
Mailing Address - Street 2:#112
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2843
Mailing Address - Country:US
Mailing Address - Phone:614-486-1123
Mailing Address - Fax:614-486-0193
Practice Address - Street 1:1500 W 3RD AVE
Practice Address - Street 2:#112
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2843
Practice Address - Country:US
Practice Address - Phone:614-486-1123
Practice Address - Fax:614-486-0193
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH194261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice