Provider Demographics
NPI:1679562318
Name:SMILEY, STEPHEN (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:SMILEY
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 1:541 CEDAR HILL AVE
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2150
Mailing Address - Country:US
Mailing Address - Phone:201-251-3888
Mailing Address - Fax:201-251-2245
Practice Address - Street 1:541 CEDAR HILL AVE
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-2150
Practice Address - Country:US
Practice Address - Phone:201-251-3888
Practice Address - Fax:201-251-2245
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ114311223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics