Provider Demographics
NPI:1770648842
Name:CELLIER, STEPHEN E (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:E
Last Name:CELLIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 N FIRELANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:43452-3030
Mailing Address - Country:US
Mailing Address - Phone:419-797-9544
Mailing Address - Fax:
Practice Address - Street 1:325 S PARK AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-2972
Practice Address - Country:US
Practice Address - Phone:419-334-7851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics