Provider Demographics
NPI:1689747057
Name:BRAZEL, STEVEN A (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:BRAZEL
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 1:520 BRIDGE PLAZA DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-1745
Mailing Address - Country:US
Mailing Address - Phone:715-273-4404
Mailing Address - Fax:732-536-2480
Practice Address - Street 1:520 BRIDGE PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-1745
Practice Address - Country:US
Practice Address - Phone:715-273-4404
Practice Address - Fax:732-536-2480
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ147821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice