Provider Demographics
NPI:1215178678
Name:STEFKO, GEOFFREY LOUIS (DDS)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:LOUIS
Last Name:STEFKO
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:P.O. BOX 429
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011
Mailing Address - Country:US
Mailing Address - Phone:888-276-4530
Mailing Address - Fax:330-483-6141
Practice Address - Street 1:36900 DETROIT ROAD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011
Practice Address - Country:US
Practice Address - Phone:888-276-4530
Practice Address - Fax:330-483-6141
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20681122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist