Provider Demographics
NPI:1730220880
Name:SEGAL, STEVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:SEGAL
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:DENTAL CENTER AT HACKENSACK UNIVERSITY MEDICAL CENTER
Mailing Address - Street 2:30 PROSPECT AVENUE
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:551-996-2111
Mailing Address - Fax:
Practice Address - Street 1:345 OLD HOOK ROAD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:201-666-9078
Practice Address - Fax:201-666-9079
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111951223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry