MEDICARE: DR. STEPHEN D FLUGER DDS

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	1223G0001X	General Practice Dentistry	032633	NY

General Provider Information

NPI Number	:	1235132788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN D FLUGER DDS

Provider Business Mailing Address
First Line	:	691 MONTAUK HWY
Second Line	:
City	:	SHIRLEY
State	:	NY
Zip	:	11967-2123
Country	:	US
Telephone Number	:	631-399-4470
Fax Number	:	631-399-1201

Provider Business Practice Location Address
First Line	:	691 MONTAUK HWY
Second Line	:
City	:	SHIRLEY
State	:	NY
Zip	:	11967-2123
Country	:	US
Telephone Number	:	631-399-4470
Fax Number	:	631-399-1201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2005
Last Update Date	:	07/08/2007

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