Provider Demographics
NPI:1710135264
Name:YAREMCZAK, STEPHEN D (DMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:YAREMCZAK
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 1:850 WOODBRIDGE CTR DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1324
Mailing Address - Country:US
Mailing Address - Phone:732-636-3220
Mailing Address - Fax:732-636-2269
Practice Address - Street 1:850 WOODBRIDGE CTR DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1324
Practice Address - Country:US
Practice Address - Phone:732-636-3220
Practice Address - Fax:732-636-2269
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01522800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist