Provider Demographics
NPI:1942372362
Name:GLICKMAN, STEVEN N (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:N
Last Name:GLICKMAN
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 1:71 FRANKLIN TPKE
Mailing Address - Street 2:SUITE 1-1
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1851
Mailing Address - Country:US
Mailing Address - Phone:201-652-1569
Mailing Address - Fax:201-652-2069
Practice Address - Street 1:71 FRANKLIN TPKE
Practice Address - Street 2:SUITE 1-1
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1851
Practice Address - Country:US
Practice Address - Phone:201-652-1569
Practice Address - Fax:201-652-2069
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ156671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice