Provider Demographics
NPI:1154303006
Name:SPECTOR, STEVEN FRED (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:FRED
Last Name:SPECTOR
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 1:43 E MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-5833
Mailing Address - Country:US
Mailing Address - Phone:631-226-1900
Mailing Address - Fax:631-226-1713
Practice Address - Street 1:43 E MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-5833
Practice Address - Country:US
Practice Address - Phone:631-226-1900
Practice Address - Fax:631-226-1713
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0390391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice