Provider Demographics
NPI:1306868278
Name:STEVEN F EISEN DMDPA
Entity type:Organization
Organization Name:STEVEN F EISEN DMDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:EISEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-449-1166
Mailing Address - Street 1:2130 HIGHWAY 35
Mailing Address - Street 2:SUITE 121
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1010
Mailing Address - Country:US
Mailing Address - Phone:732-449-1166
Mailing Address - Fax:732-449-3344
Practice Address - Street 1:2130 HIGHWAY 35
Practice Address - Street 2:SUITE 121
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1010
Practice Address - Country:US
Practice Address - Phone:732-449-1166
Practice Address - Fax:732-449-3344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ131091223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty