Provider Demographics
NPI:1649408550
Name:APPELBAUM, KEITH STEPHAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:STEPHAN
Last Name:APPELBAUM
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 1:51 HICKORY WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-1359
Mailing Address - Country:US
Mailing Address - Phone:973-398-7271
Mailing Address - Fax:
Practice Address - Street 1:1 PROFESSIONAL QUADRANGLE
Practice Address - Street 2:SUITE 5
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2330
Practice Address - Country:US
Practice Address - Phone:973-598-3450
Practice Address - Fax:973-598-3455
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02411400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist