Provider Demographics
NPI:1306925607
Name:SUDEN, STEPHEN C (DDS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:SUDEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5229 E TRINDLE ROAD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050
Mailing Address - Country:US
Mailing Address - Phone:717-697-4606
Mailing Address - Fax:717-697-0573
Practice Address - Street 1:5229 E TRINDLE ROAD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050
Practice Address - Country:US
Practice Address - Phone:717-697-4606
Practice Address - Fax:717-697-0573
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0170161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice