Provider Demographics
NPI:1740453877
Name:STEVEN FACTOR
Entity type:Organization
Organization Name:STEVEN FACTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FACTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-569-9393
Mailing Address - Street 1:240 E PALISADE AVE
Mailing Address - Street 2:SUITE C-11
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3169
Mailing Address - Country:US
Mailing Address - Phone:201-569-9393
Mailing Address - Fax:
Practice Address - Street 1:240 E PALISADE AVE
Practice Address - Street 2:SUITE C-11
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3169
Practice Address - Country:US
Practice Address - Phone:201-569-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI011792001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty