Provider Demographics
NPI:1942588603
Name:PUFFER, STEVEN FREDERICK (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:FREDERICK
Last Name:PUFFER
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:PO BOX 631278
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75963-1278
Mailing Address - Country:US
Mailing Address - Phone:936-564-2439
Mailing Address - Fax:936-560-9456
Practice Address - Street 1:1211 PARK ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4896
Practice Address - Country:US
Practice Address - Phone:936-546-2437
Practice Address - Fax:936-560-9456
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-4476122300000X
TX30733122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist