Provider Demographics
NPI:1689685968
Name:ZDEP, STEVEN R (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:ZDEP
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1 LINCOLN CTR
Mailing Address - Street 2:SUITE 1070
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-1324
Mailing Address - Country:US
Mailing Address - Phone:315-471-6188
Mailing Address - Fax:315-471-0271
Practice Address - Street 1:1 LINCOLN CTR
Practice Address - Street 2:SUITE 1070
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-1324
Practice Address - Country:US
Practice Address - Phone:315-471-6188
Practice Address - Fax:315-471-0271
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
NY0506371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02461489Medicaid