Provider Demographics
NPI:1134664824
Name:TRUMAN, STEVEN (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:TRUMAN
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 1:1718 LEXINGTON AVE
Mailing Address - Street 2:APT A
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-1972
Mailing Address - Country:US
Mailing Address - Phone:435-313-3881
Mailing Address - Fax:
Practice Address - Street 1:1718 LEXINGTON AVE
Practice Address - Street 2:APT A
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-1972
Practice Address - Country:US
Practice Address - Phone:435-313-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS101105122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist