Provider Demographics
NPI:1235290222
Name:CAMPOLATTARO, STEVEN A (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:CAMPOLATTARO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 STATE ROUTE 10 W
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1731
Mailing Address - Country:US
Mailing Address - Phone:973-598-1601
Mailing Address - Fax:973-598-1618
Practice Address - Street 1:22 STATE ROUTE 10 W
Practice Address - Street 2:SUITE 102
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1731
Practice Address - Country:US
Practice Address - Phone:973-598-1601
Practice Address - Fax:973-598-1618
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI187341223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics