Provider Demographics
NPI:1790803872
Name:FONTANA, STEVEN JOHN (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOHN
Last Name:FONTANA
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
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Mailing Address - Street 1:1585 PINE RIDGE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2105
Mailing Address - Country:US
Mailing Address - Phone:239-262-3300
Mailing Address - Fax:239-262-3333
Practice Address - Street 1:1585 PINE RIDGE RD STE 2
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2105
Practice Address - Country:US
Practice Address - Phone:239-262-3300
Practice Address - Fax:239-262-3333
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2013-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLDN151511223S0112X
FLME960061223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery