MEDICARE: STEVEN A PUMA, D.D.S., LLC

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	DI14201	NJ

General Provider Information

NPI Number	:	1750450672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN A PUMA, D.D.S., LLC

Provider Business Mailing Address
First Line	:	15 SUNNY RIDGE DR
Second Line	:
City	:	FAIR HAVEN
State	:	NJ
Zip	:	07704-3645
Country	:	US
Telephone Number	:	732-549-3114
Fax Number	:	732-549-3115

Provider Business Practice Location Address
First Line	:	373 FORD AVE
Second Line	:
City	:	FORDS
State	:	NJ
Zip	:	08863-1232
Country	:	US
Telephone Number	:	732-549-3114
Fax Number	:	732-549-3115

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. STEVEN A PUMA
Credential	:	D.D.S.
Telephone Number	:	732-549-3114

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/22/2020

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