Provider Demographics
NPI:1023130705
Name:ABBOTT, STEVEN J (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:ABBOTT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 STORRS RD
Mailing Address - Street 2:STORRS ENDODONTICS LLC
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06268
Mailing Address - Country:US
Mailing Address - Phone:860-429-2051
Mailing Address - Fax:860-429-2053
Practice Address - Street 1:1733 STORRS RD
Practice Address - Street 2:
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06268
Practice Address - Country:US
Practice Address - Phone:860-429-2051
Practice Address - Fax:860-429-2053
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0081181223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics