Provider Demographics
NPI:1114047198
Name:COSGRIFF, STEPHEN GERARD (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GERARD
Last Name:COSGRIFF
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 1:304 HACKENSACK ST
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-1300
Mailing Address - Country:US
Mailing Address - Phone:201-531-0008
Mailing Address - Fax:201-438-5979
Practice Address - Street 1:304 HACKENSACK ST
Practice Address - Street 2:
Practice Address - City:WOOD RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07075-1300
Practice Address - Country:US
Practice Address - Phone:201-531-0008
Practice Address - Fax:201-438-5979
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI167451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice