Provider Demographics
NPI:1609218528
Name:STEVEN TAM, DMD, PC
Entity Type:Organization
Organization Name:STEVEN TAM, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-592-1885
Mailing Address - Street 1:4225 80TH ST
Mailing Address - Street 2:UNIT LA
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3070
Mailing Address - Country:US
Mailing Address - Phone:718-592-1885
Mailing Address - Fax:718-592-2034
Practice Address - Street 1:4225 80TH ST
Practice Address - Street 2:UNIT LA
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3070
Practice Address - Country:US
Practice Address - Phone:718-592-1885
Practice Address - Fax:718-592-2034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042748122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty