Provider Demographics
NPI:1790868222
Name:KAZMIERCZAK, STEPHEN T (DMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:T
Last Name:KAZMIERCZAK
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 1:6 MARIAN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914
Mailing Address - Country:US
Mailing Address - Phone:215-822-1580
Mailing Address - Fax:
Practice Address - Street 1:204 NORTH WEST ST SUITE 104
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:215-345-6500
Practice Address - Fax:215-345-6501
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019479L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist