Provider Demographics
NPI:1750442364
Name:SULZBACH, STEPHEN E (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:E
Last Name:SULZBACH
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 1:2020 PEEVY RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18041-2304
Mailing Address - Country:US
Mailing Address - Phone:215-900-0008
Mailing Address - Fax:
Practice Address - Street 1:2299 BRODHEAD RD STE K
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8990
Practice Address - Country:US
Practice Address - Phone:610-790-8785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0377561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice