Provider Demographics
NPI:1457497042
Name:STECZKO, TED S (DDS)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:S
Last Name:STECZKO
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 1:8520 ELMHURST AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3351
Mailing Address - Country:US
Mailing Address - Phone:718-426-1212
Mailing Address - Fax:
Practice Address - Street 1:8520 ELMHURST AVE STE 1B
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3351
Practice Address - Country:US
Practice Address - Phone:718-426-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice