Provider Demographics
NPI:1629291356
Name:KAUFMAN, STEPHEN M (DDS)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:M
Last Name:KAUFMAN
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 1:202 C MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015
Mailing Address - Country:US
Mailing Address - Phone:615-792-3790
Mailing Address - Fax:615-792-3759
Practice Address - Street 1:202 C MAIN STREET
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015
Practice Address - Country:US
Practice Address - Phone:615-792-3790
Practice Address - Fax:615-792-3759
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN53101223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery