Provider Demographics
NPI:1659478097
Name:SIERSCHULA, STEVEN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:SIERSCHULA
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 1:4055 FAR HILLS AVENUE
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2440
Mailing Address - Country:US
Mailing Address - Phone:937-299-3691
Mailing Address - Fax:937-293-0126
Practice Address - Street 1:4055 FAR HILLS AVENUE
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2440
Practice Address - Country:US
Practice Address - Phone:937-299-3691
Practice Address - Fax:937-293-0126
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH166931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice