Provider Demographics
NPI:1639192461
Name:SPECTOR, STEPHEN HAYES (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:HAYES
Last Name:SPECTOR
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 1:194 JACK MARTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7769
Mailing Address - Country:US
Mailing Address - Phone:732-458-1400
Mailing Address - Fax:
Practice Address - Street 1:194 JACK MARTIN BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7769
Practice Address - Country:US
Practice Address - Phone:732-458-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ125071223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics