Provider Demographics
NPI:1982612552
Name:LOVELACE, STEVEN MARC (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARC
Last Name:LOVELACE
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 1:935 MAIN ST
Mailing Address - Street 2:LEVEL A
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6059
Mailing Address - Country:US
Mailing Address - Phone:860-649-0238
Mailing Address - Fax:860-645-7515
Practice Address - Street 1:935 MAIN ST
Practice Address - Street 2:LEVEL A
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6059
Practice Address - Country:US
Practice Address - Phone:860-649-0238
Practice Address - Fax:860-645-7515
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT50391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice