Provider Demographics
NPI:1114906328
Name:STERNHAGEN, PAUL GUY (DDS, FAGD, FDOCS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GUY
Last Name:STERNHAGEN
Suffix:
Gender:M
Credentials:DDS, FAGD, FDOCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 E EIGHTH ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-2750
Mailing Address - Country:US
Mailing Address - Phone:231-947-8586
Mailing Address - Fax:231-947-8115
Practice Address - Street 1:932 E EIGHTH ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-2750
Practice Address - Country:US
Practice Address - Phone:231-947-8586
Practice Address - Fax:231-947-8115
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14217122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist