Provider Demographics
NPI:1801017819
Name:CELANI, STEPHEN C (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:CELANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 EAST BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HAZELTON
Mailing Address - State:PA
Mailing Address - Zip Code:18201
Mailing Address - Country:US
Mailing Address - Phone:570-455-6058
Mailing Address - Fax:570-455-6058
Practice Address - Street 1:21 EAST BROAD ST
Practice Address - Street 2:
Practice Address - City:HAZELTON
Practice Address - State:PA
Practice Address - Zip Code:18201
Practice Address - Country:US
Practice Address - Phone:570-455-6058
Practice Address - Fax:570-455-6058
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018299L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist