Doctor Name: | DR. DMITRY STILLMAN |
NPI Number: | 1275522880 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DDS |
License Number: | DI19909 |
Business Practice Address: | 45 Winant Avenue Ridgefield Park, NJ - 076601925 |
Business Phone Number: | 2014402100 |
Business Fax Number: | 2014401279 |
Mailing Address: | 35 Journal Sq, Suite 601 JERSEY CITY |
State: | NJ |
Postal Code: | 073064011 |
Phone Number: | 2013860353 |
Fax Number: | 2013860356 |
NPI Enumeration Date: | 10/17/2005 |
NPI Last Update Date: | 07/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | DI19909 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |