Provider Demographics
NPI:1649269176
Name:URELES, STEVEN D (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:URELES
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:190 HEMPSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-6248
Mailing Address - Country:US
Mailing Address - Phone:860-447-3216
Mailing Address - Fax:860-701-6019
Practice Address - Street 1:190 HEMPSTEAD ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-6248
Practice Address - Country:US
Practice Address - Phone:860-447-3216
Practice Address - Fax:860-701-6019
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT73481223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2073485Medicaid