Provider Demographics
NPI:1891995692
Name:KEST, STEPHEN ERIC (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ERIC
Last Name:KEST
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 1:250 MAIN ST S
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-2263
Mailing Address - Country:US
Mailing Address - Phone:203-405-6301
Mailing Address - Fax:203-405-6302
Practice Address - Street 1:250 MAIN ST S
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-2263
Practice Address - Country:US
Practice Address - Phone:203-405-6301
Practice Address - Fax:203-405-6302
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0535741223P0221X
CT0098721223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry