MEDICARE: STEVEN H BACKER DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144318015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN H BACKER DDS PC

Provider Business Mailing Address
First Line	:	690 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-6007
Country	:	US
Telephone Number	:	718-693-8200
Fax Number	:	718-693-8264

Provider Business Practice Location Address
First Line	:	690 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-6007
Country	:	US
Telephone Number	:	718-693-8200
Fax Number	:	718-693-8264

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEVEN BACKER
Credential	:	DDS
Telephone Number	:	718-693-8200

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	12/06/2007

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