Provider Demographics
NPI:1487642435
Name:RECUPERO, STEPHEN E (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:E
Last Name:RECUPERO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:B
Other - Last Name:RECUPERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:480 PARK ST
Mailing Address - Street 2:P O BOX 360
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3085
Mailing Address - Country:US
Mailing Address - Phone:781-344-5211
Mailing Address - Fax:781-297-2049
Practice Address - Street 1:480 PARK ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3085
Practice Address - Country:US
Practice Address - Phone:781-344-5211
Practice Address - Fax:781-297-2049
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA189261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice