Provider Demographics
NPI:1760702070
Name:BRISMAN, STEVEN A (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:BRISMAN
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 1:30 POPHAM RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4134
Mailing Address - Country:US
Mailing Address - Phone:914-725-7100
Mailing Address - Fax:
Practice Address - Street 1:30 POPHAM RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4134
Practice Address - Country:US
Practice Address - Phone:914-725-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03982611223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics