Provider Demographics
NPI:1356547566
Name:STIEFEL, DANIEL B (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:B
Last Name:STIEFEL
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 1:187 GREAT RD
Mailing Address - Street 2:APT. A-10
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-5737
Mailing Address - Country:US
Mailing Address - Phone:617-504-1688
Mailing Address - Fax:
Practice Address - Street 1:50 STANIFORD ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2517
Practice Address - Country:US
Practice Address - Phone:617-523-6633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208631223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics