Provider Demographics
NPI:1447401187
Name:DEETS, STEVEN HAROLD (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:HAROLD
Last Name:DEETS
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 1:312 N TYSON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-3121
Mailing Address - Country:US
Mailing Address - Phone:215-892-3242
Mailing Address - Fax:
Practice Address - Street 1:312 N TYSON AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-3121
Practice Address - Country:US
Practice Address - Phone:215-892-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037657122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist