Provider Demographics
NPI:1467686527
Name:SOZANSKI, STEPHEN ROBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ROBERT
Last Name:SOZANSKI
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 1:27 RIVER RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:NEWCASTLE
Mailing Address - State:ME
Mailing Address - Zip Code:04553-3845
Mailing Address - Country:US
Mailing Address - Phone:207-563-8484
Mailing Address - Fax:207-563-8484
Practice Address - Street 1:27 RIVER RD
Practice Address - Street 2:SUITE 10
Practice Address - City:NEWCASTLE
Practice Address - State:ME
Practice Address - Zip Code:04553-3845
Practice Address - Country:US
Practice Address - Phone:207-563-8481
Practice Address - Fax:207-563-8484
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN36381223E0200X
MA137251223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics