Provider Demographics
NPI:1851315659
Name:EISEN, STEVEN F (DMD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:F
Last Name:EISEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GAIL CT
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3763
Mailing Address - Country:US
Mailing Address - Phone:732-493-0233
Mailing Address - Fax:732-449-3344
Practice Address - Street 1:2130 HIGHWAY 35
Practice Address - Street 2:SUITE 121
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1010
Practice Address - Country:US
Practice Address - Phone:732-449-1166
Practice Address - Fax:732-449-3344
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ131091223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics