Provider Demographics
NPI:1629144811
Name:PITTMAN, STEVEN V (DMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:V
Last Name:PITTMAN
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 1:113 WATER ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3021
Mailing Address - Country:US
Mailing Address - Phone:508-473-7900
Mailing Address - Fax:508-473-7914
Practice Address - Street 1:113 WATER ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3021
Practice Address - Country:US
Practice Address - Phone:508-473-7900
Practice Address - Fax:508-473-7914
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171181223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX06276OtherBLUE CROSS
MA16294OtherHARVARD PILGRIM
MA18038OtherFALLON
MA723970OtherTUFTS
MA723970OtherTUFTS
MAX06276OtherBLUE CROSS