Provider Demographics
NPI:1841317807
Name:ADUBATO, STEPHEN R (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:ADUBATO
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 1:260 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1993
Mailing Address - Country:US
Mailing Address - Phone:973-667-6042
Mailing Address - Fax:
Practice Address - Street 1:260 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1993
Practice Address - Country:US
Practice Address - Phone:973-667-6042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI014623001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice