Provider Demographics
NPI:1215978663
Name:CALDWELL, STEPHEN F (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 PEABODY ROAD ANX
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1724
Mailing Address - Country:US
Mailing Address - Phone:603-434-6433
Mailing Address - Fax:603-434-6133
Practice Address - Street 1:4 PEABODY ROAD ANX
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1724
Practice Address - Country:US
Practice Address - Phone:603-434-6433
Practice Address - Fax:603-434-6133
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10017801223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH89192060Medicaid