Healthcare Provider Details

I. General information

NPI: 1841403284
Provider Name (Legal Business Name): STEVEN HOWARD DWECK DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 MAPLE AVE
SARATOGA SPRINGS NY
12866-5507
US

IV. Provider business mailing address

450 MAPLE AVE
SARATOGA SPRINGS NY
12866-5507
US

V. Phone/Fax

Practice location:
  • Phone: 518-587-7512
  • Fax: 518-587-4738
Mailing address:
  • Phone: 518-587-7512
  • Fax: 518-587-4738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number045960
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: