Provider Demographics
NPI:1679709075
Name:STEVEN KUPFERMAN DMD MD INC
Entity Type:Organization
Organization Name:STEVEN KUPFERMAN DMD MD INC
Other - Org Name:CENTURY MAXILLOFACIAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUPFERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MD
Authorized Official - Phone:310-842-4811
Mailing Address - Street 1:2080 CENTURY PARK EAST BLVD
Mailing Address - Street 2:SUITE 710
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067
Mailing Address - Country:US
Mailing Address - Phone:310-842-4811
Mailing Address - Fax:
Practice Address - Street 1:2080 CENTURY PARK EAST BLVD
Practice Address - Street 2:SUITE 710
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067
Practice Address - Country:US
Practice Address - Phone:310-842-4811
Practice Address - Fax:310-861-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty