Provider Demographics
NPI:1720248487
Name:HAYWOOD, STEVEN WURSTER (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WURSTER
Last Name:HAYWOOD
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 1:4 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1527
Mailing Address - Country:US
Mailing Address - Phone:717-235-3871
Mailing Address - Fax:717-235-6986
Practice Address - Street 1:4 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1527
Practice Address - Country:US
Practice Address - Phone:717-235-3871
Practice Address - Fax:717-235-6986
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029898L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist