Provider Demographics
NPI:1194739508
Name:GUTTENBERG, STEVEN ALAN (DDS MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ALAN
Last Name:GUTTENBERG
Suffix:
Gender:M
Credentials:DDS MD
Other - Prefix:
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Mailing Address - Street 1:2021 K STREET NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1003
Mailing Address - Country:US
Mailing Address - Phone:202-466-3323
Mailing Address - Fax:202-466-5236
Practice Address - Street 1:2021 K STREET NW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1003
Practice Address - Country:US
Practice Address - Phone:202-466-3323
Practice Address - Fax:202-466-5236
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DC2934204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
179555Medicare ID - Type Unspecified
T31016Medicare UPIN