Provider Demographics
NPI:1720099583
Name:FASSMAN, STEPHEN HOWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:HOWARD
Last Name:FASSMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:STEPHEN
Other - Middle Name:H
Other - Last Name:FASSMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD,PC
Mailing Address - Street 1:35 E 35TH ST
Mailing Address - Street 2:1K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3823
Mailing Address - Country:US
Mailing Address - Phone:212-689-2000
Mailing Address - Fax:646-536-7537
Practice Address - Street 1:35 E 35TH ST
Practice Address - Street 2:1K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3823
Practice Address - Country:US
Practice Address - Phone:212-689-2000
Practice Address - Fax:646-536-7537
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist