Provider Demographics
NPI:1740409440
Name:SEDAROS, STEVE ADLAI (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:ADLAI
Last Name:SEDAROS
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 1:2301 WEST EAU GALLIE BLVD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935
Mailing Address - Country:US
Mailing Address - Phone:321-610-7868
Mailing Address - Fax:321-610-7818
Practice Address - Street 1:2301 WEST EAU GALLIE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935
Practice Address - Country:US
Practice Address - Phone:321-610-7868
Practice Address - Fax:321-610-7818
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN168451223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery