Provider Demographics
NPI:1396722617
Name:GUY, STEVEN CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CHARLES
Last Name:GUY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:205 ONEIDA STREET
Mailing Address - Street 2:FULTON DENTAL HEALTH ASSO
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13609
Mailing Address - Country:US
Mailing Address - Phone:315-598-3700
Mailing Address - Fax:315-592-4760
Practice Address - Street 1:1131 COMMERCE PARK DRIVE E
Practice Address - Street 2:WATERTOWN DENTAL HEALTH GROUP
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601
Practice Address - Country:US
Practice Address - Phone:315-788-1070
Practice Address - Fax:315-785-1039
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0448251223P0300X
OH155891223P0300X
VA84931223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2496913Medicaid
NY994825OtherDELTA DENTAL
NY890478OtherUNITED CONCORDIA